45D2219913 CLIA NUMBER - JMTI, INC DBA USAMDT PLANO

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Laboratory Demographics

CLIA Number: 45D2219913

Facility Name: JMTI, INC DBA USAMDT PLANO

Facility Address:
5700 TENNYSON PARKWAY SUITE 300
PLANO, TX
ZIP 75024
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Facility Phone Number: 469 573-0547

Facility Type: Community Clinic

Certificate Type: Waiver

NPI Number: 1386236800

Taxonomy: 261Q00000X - Clinic/Center
A facility or distinct part of one used for the diagnosis and treatment of outpatients. Clinic/Center is irregularly defined, sometimes being limited to organizations serving specialized treatment requirements or distinct patient/client groups (e.g., radiology, poor, and public health).

CLIA Record

Field Name	Field Value
CLIA Number	45D2219913
LAB Type	Community Clinic
Facility Name	JMTI, INC DBA USAMDT PLANO
Street	5700 TENNYSON PARKWAY SUITE 300
City	PLANO
State	TX
ZIP	75024
Phone	469 573-0547
CertificateType	4
CertificateEffectiveDate	12/13/2023
CertificateExpirationDate	12/12/2025
FacilityType	Waiver

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