45D2263493 CLIA NUMBER - CLINICA GUADALAUPE MESQUITE, LLC

Laboratory Demographics

  • CLIA Code: 45D2263493
  • Facility Name: CLINICA GUADALAUPE MESQUITE, LLC
  • Facility Address: 1100 N TOWN EAST BLVD SUITE 102
    MESQUITE, TX
    ZIP 75150
  • Facility Phone: 469 606-0753
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: LEEOR B. PELEG
  • NPI Number: 1649703430
  • Taxonomy: 363LF0000X - Nurse Practitioner

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CLIA Record

Field Name Field Value
CLIA Number 45D2263493
LAB Type Physician Office
Facility Name CLINICA GUADALAUPE MESQUITE, LLC
Street 1100 N TOWN EAST BLVD SUITE 102
City MESQUITE
State TX
ZIP 75150
Phone 469 606-0753
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 6/29/2024
Certificate Expiration Date 6/28/2026
Facility Type Physician Office
Lab Director LEEOR B. PELEG

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