45D2243722 CLIA NUMBER - CONSULTORIO GENERAL HISPANO

Laboratory Demographics

  • CLIA Code: 45D2243722
  • Facility Name: CONSULTORIO GENERAL HISPANO
  • Facility Address: 2502 S BELT LINE RD SUITE 400
    GRAND PRAIRIE, TX
    ZIP 75052
  • Facility Phone: 214 518-6988
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: ANTONIO BRIZUELA
  • NPI Number: 1528642402
  • Taxonomy: 363LF0000X - Nurse Practitioner

Map and Directions

Get Directions

CLIA Record

Field Name Field Value
CLIA Number 45D2243722
LAB Type Physician Office
Facility Name CONSULTORIO GENERAL HISPANO
Street 2502 S BELT LINE RD SUITE 400
City GRAND PRAIRIE
State TX
ZIP 75052
Phone 214 518-6988
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 11/22/2023
Certificate Expiration Date 11/21/2025
Facility Type Physician Office
Lab Director ANTONIO BRIZUELA

Download Record

Download this CLIA record record in Text format: Export

Download this CLIA record record in Excel (CSV) format: Export

Download this CLIA record record in XML format: Export

This page was last updated on: 9/29/2025