45D2216796 CLIA NUMBER - BAYLOR SCOTT & WHIE MEDPROVIDER

Laboratory Demographics

CLIA Number: 45D2216796

Facility Name: BAYLOR SCOTT & WHIE MEDPROVIDER

Facility Address:
3417 GASTON AVE SUITE 1100
DALLAS, TX
ZIP 75246
Get Directions

Facility Phone Number: 469 800-9000

Facility Type: Physician Office

Certificate Type: Waiver

NPI Number: 1811995913

Taxonomy: 261QA1903X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	45D2216796
LAB Type	Physician Office
Facility Name	BAYLOR SCOTT & WHIE MEDPROVIDER
Street	3417 GASTON AVE SUITE 1100
City	DALLAS
State	TX
ZIP	75246
Phone	469 800-9000
CertificateType	4
CertificateEffectiveDate	3/16/2023
CertificateExpirationDate	3/15/2025
FacilityType	Waiver

Download Record

Export to text format icon Download this CLIA NUMBER record in Text format: Export

Export to text format icon Download this CLIA NUMBER record in Excel (CSV) format: Export

Export to text format icon Download this CLIA NUMBER record in XML format: Export

This page was last updated on: 4/23/2024