45D2268295 CLIA NUMBER - BAYLOR SCOTT & WHITE - DALLAS DIAGNOSTIC ASSOCIATION OF PLANO - RADIOLOGY

Laboratory Demographics

CLIA Number: 45D2268295

Facility Name: BAYLOR SCOTT & WHITE - DALLAS DIAGNOSTIC ASSOCIATION OF PLANO - RADIOLOGY

Facility Address:
4716 ALLIANCE BLVD SUITE 600
PLANO, TX
ZIP 75093
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Facility Phone Number: 469 800-6000

Facility Type: Physician Office

Certificate Type: Waiver

NPI Number: 1962681130

Taxonomy: 261QA1903X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	45D2268295
LAB Type	Physician Office
Facility Name	BAYLOR SCOTT & WHITE - DALLAS DIAGNOSTIC ASSOCIATION OF PLANO - RADIOLOGY
Street	4716 ALLIANCE BLVD SUITE 600
City	PLANO
State	TX
ZIP	75093
Phone	469 800-6000
CertificateType	4
CertificateEffectiveDate	9/8/2022
CertificateExpirationDate	9/7/2024
FacilityType	Waiver

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This page was last updated on: 4/23/2024