45D2270438 CLIA NUMBER - CANDID PRIMARY CARE

Laboratory Demographics

  • CLIA Code: 45D2270438
  • Facility Name: CANDID PRIMARY CARE
  • Facility Address: 546 E SANDY LAKE RD SUITE 120
    COPPELL, TX
    ZIP 75019
  • Facility Phone: 469 619-7192
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: ALI MONSUR
  • NPI Number: 1528795218
  • Taxonomy: 207R00000X - Internal Medicine

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CLIA Record

Field Name Field Value
CLIA Number 45D2270438
LAB Type Physician Office
Facility Name CANDID PRIMARY CARE
Street 546 E SANDY LAKE RD SUITE 120
City COPPELL
State TX
ZIP 75019
Phone 469 619-7192
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 10/14/2024
Certificate Expiration Date 10/13/2026
Facility Type Physician Office
Lab Director ALI MONSUR

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