45D2276445 CLIA NUMBER - MUSGRAVE SPECIALIZED CARE, PLLC

Laboratory Demographics

  • CLIA Code: 45D2276445
  • Facility Name: MUSGRAVE SPECIALIZED CARE, PLLC
  • Facility Address: 3061 W SOUTHLAKE BLVD
    SOUTHLAKE, TX
    ZIP 76092
  • Facility Phone: 817 928-3335
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: WILLIAM MUSGRAVE
  • NPI Number: 1750008181
  • Taxonomy: 207Q00000X - Family Medicine

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CLIA Record

Field Name Field Value
CLIA Number 45D2276445
LAB Type Physician Office
Facility Name MUSGRAVE SPECIALIZED CARE, PLLC
Street 3061 W SOUTHLAKE BLVD
City SOUTHLAKE
State TX
ZIP 76092
Phone 817 928-3335
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 2/8/2025
Certificate Expiration Date 2/7/2027
Facility Type Physician Office
Lab Director WILLIAM MUSGRAVE

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