45D2254743 CLIA NUMBER - PUREPATH LAB & THERAPEUTICS, LLC

Laboratory Demographics

  • CLIA Code: 45D2254743
  • Facility Name: PUREPATH LAB & THERAPEUTICS, LLC
  • Facility Address: 8204 ELMBROOK DR SUITE 221
    DALLAS, TX
    ZIP 75247
  • Facility Phone: 469 464-4522
  • Facility Type: Independent
  • Facility Type: Waiver
  • Lab Director: DR. ANUP R. TILAK
  • NPI Number: 1043964257
  • Taxonomy: 291U00000X - Clinical Medical Laboratory

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CLIA Record

Field Name Field Value
CLIA Number 45D2254743
LAB Type Independent
Facility Name PUREPATH LAB & THERAPEUTICS, LLC
Street 8204 ELMBROOK DR SUITE 221
City DALLAS
State TX
ZIP 75247
Phone 469 464-4522
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 2/10/2025
Certificate Expiration Date 2/9/2027
Facility Type Independent
Lab Director DR. ANUP R. TILAK

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