45D2275787 CLIA NUMBER - JEREMIAH SISAY PHARMD, MD, PLLC

Laboratory Demographics

  • CLIA Code: 45D2275787
  • Facility Name: JEREMIAH SISAY PHARMD, MD, PLLC
  • Facility Address: 2698 N GALLOWAY AVE SUITE 101
    MESQUITE, TX
    ZIP 75150
  • Facility Phone: 972 288-1662
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: JEREMIAH K. SISAY
  • NPI Number: 1194098111
  • Taxonomy: 207R00000X - Internal Medicine

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CLIA Record

Field Name Field Value
CLIA Number 45D2275787
LAB Type Physician Office
Facility Name JEREMIAH SISAY PHARMD, MD, PLLC
Street 2698 N GALLOWAY AVE SUITE 101
City MESQUITE
State TX
ZIP 75150
Phone 972 288-1662
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 1/27/2025
Certificate Expiration Date 1/26/2027
Facility Type Physician Office
Lab Director JEREMIAH K. SISAY

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