45D2255810 CLIA NUMBER - TOTAL CARE PRIMARY CARE

Laboratory Demographics

  • CLIA Code: 45D2255810
  • Facility Name: TOTAL CARE PRIMARY CARE
  • Facility Address: 143 S DENTON TAP RD SUITE 180
    COPPELL, TX
    ZIP 75019
  • Facility Phone: 469 564-1119
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: JUAN CARLOS MOLINA
  • NPI Number: 1508144148
  • Taxonomy: 291U00000X - Clinical Medical Laboratory

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CLIA Record

Field Name Field Value
CLIA Number 45D2255810
LAB Type Physician Office
Facility Name TOTAL CARE PRIMARY CARE
Street 143 S DENTON TAP RD SUITE 180
City COPPELL
State TX
ZIP 75019
Phone 469 564-1119
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 3/17/2024
Certificate Expiration Date 3/16/2026
Facility Type Physician Office
Lab Director JUAN CARLOS MOLINA

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