45D2294088 CLIA NUMBER - ADVOCATE PRIMARY CARE

Laboratory Demographics

  • CLIA Code: 45D2294088
  • Facility Name: ADVOCATE PRIMARY CARE
  • Facility Address: 370 STATE HIGHWAY 121 SUITE 100
    COPPELL, TX
    ZIP 75019
  • Facility Phone: 972 382-5761
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: RAFHAN RAFI
  • NPI Number: 1023715752
  • Taxonomy: 261QP2300X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 45D2294088
LAB Type Physician Office
Facility Name ADVOCATE PRIMARY CARE
Street 370 STATE HIGHWAY 121 SUITE 100
City COPPELL
State TX
ZIP 75019
Phone 972 382-5761
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 11/17/2023
Certificate Expiration Date 11/16/2025
Facility Type Physician Office
Lab Director RAFHAN RAFI

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