45D2251737 CLIA NUMBER - CENTRUM MEDICAL GROUP, PLLC

Laboratory Demographics

  • CLIA Code: 45D2251737
  • Facility Name: CENTRUM MEDICAL GROUP, PLLC
  • Facility Address: 2355 E GRAPEVINE MILLS CIR
    GRAPEVINE, TX
    ZIP 76051
  • Facility Phone: (305) 266-2929
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: AYESHA S. KHAN
  • NPI Number: 1003422312
  • Taxonomy: 261Q00000X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 45D2251737
LAB Type Physician Office
Facility Name CENTRUM MEDICAL GROUP, PLLC
Street 2355 E GRAPEVINE MILLS CIR
City GRAPEVINE
State TX
ZIP 76051
Phone 3052662929
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 2/4/2026
Certificate Expiration Date 2/3/2028
Facility Type Physician Office
Lab Director AYESHA S. KHAN

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This page was last updated on: 5/18/2026