45D2284511 CLIA NUMBER - TEXAS HEALTH INTERNAL MEDICINE RESIDENCY CLINIC

Laboratory Demographics

  • CLIA Code: 45D2284511
  • Facility Name: TEXAS HEALTH INTERNAL MEDICINE RESIDENCY CLINIC
  • Facility Address: 7000 W PLANO PKWY SUITE 250
    PLANO, TX
    ZIP 75093
  • Facility Phone: 972 981-7255
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: ISITRI MODAK
  • NPI Number: 1568565778
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 45D2284511
LAB Type Physician Office
Facility Name TEXAS HEALTH INTERNAL MEDICINE RESIDENCY CLINIC
Street 7000 W PLANO PKWY SUITE 250
City PLANO
State TX
ZIP 75093
Phone 972 981-7255
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 6/23/2023
Certificate Expiration Date 6/22/2025
Facility Type Physician Office
Lab Director ISITRI MODAK

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This page was last updated on: 3/20/2025