45D2259399 CLIA NUMBER - ARC SERENITY SERVICE, LLC

Laboratory Demographics

  • CLIA Code: 45D2259399
  • Facility Name: ARC SERENITY SERVICE, LLC
  • Facility Address: 13521 MONFORT DR
    DALLAS, TX
    ZIP 75240
  • Facility Phone: 214 302-7171
  • Facility Type: Practitioner Other
  • Facility Type: Waiver
  • Lab Director: JEBEH O. BAIMBA
  • NPI Number: 1659092096
  • Taxonomy: 363LF0000X - Nurse Practitioner

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CLIA Record

Field Name Field Value
CLIA Number 45D2259399
LAB Type Practitioner Other
Facility Name ARC SERENITY SERVICE, LLC
Street 13521 MONFORT DR
City DALLAS
State TX
ZIP 75240
Phone 214 302-7171
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 5/5/2024
Certificate Expiration Date 5/4/2026
Facility Type Practitioner Other
Lab Director JEBEH O. BAIMBA

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This page was last updated on: 6/4/2025