45D2249684 CLIA NUMBER - EDWARDS ELITE LABS EXPRESS

Laboratory Demographics

  • CLIA Code: 45D2249684
  • Facility Name: EDWARDS ELITE LABS EXPRESS
  • Facility Address: 5943 RIDGEWAY DR
    GRAND PRAIRIE, TX
    ZIP 75052
  • Facility Phone: 972 209-6437
  • Facility Type: Other - TEMP TESTING CLINIC
  • Facility Type: Waiver
  • Lab Director: TANISHA T. EDWARDS
  • NPI Number: 1457002933
  • Taxonomy: 291U00000X - Clinical Medical Laboratory

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CLIA Record

Field Name Field Value
CLIA Number 45D2249684
LAB Type Other - TEMP TESTING CLINIC
Facility Name EDWARDS ELITE LABS EXPRESS
Street 5943 RIDGEWAY DR
City GRAND PRAIRIE
State TX
ZIP 75052
Phone 972 209-6437
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 1/21/2024
Certificate Expiration Date 1/20/2026
Facility Type Other - TEMP TESTING CLINIC
Lab Director TANISHA T. EDWARDS

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