45D2295947 CLIA NUMBER - ENVISION IMAGING FLOWER MOUND

Laboratory Demographics

CLIA Number: 45D2295947

Facility Name: ENVISION IMAGING FLOWER MOUND

Facility Address:
4640 LONG PRAIRIE RD SUITE 310
FLOWER MOUND, TX
ZIP 75028
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Facility Phone Number: 469 902-6500

Facility Type: Other - OUTPATIENT DIAG IMAGING

Certificate Type: Waiver

NPI Number: 1942081153

Taxonomy: 293D00000X - Physiological Laboratory
A laboratory that operates independently of a hospital and physician's office to furnish physiological diagnostic services (e.g. EEG's , EKG's, scans, etc.). Facilities offering ONLY physiological services are not certified as independent laboratories. If an independent laboratory offers physiological services IN ADDITION to clinical laboratory services, they are surveyed only for compliance with the clinical laboratory regulations because there are no health and safety regulations for physiological services.

CLIA Record

Field Name	Field Value
CLIA Number	45D2295947
LAB Type	Other - OUTPATIENT DIAG IMAGING
Facility Name	ENVISION IMAGING FLOWER MOUND
Street	4640 LONG PRAIRIE RD SUITE 310
City	FLOWER MOUND
State	TX
ZIP	75028
Phone	469 902-6500
CertificateType	4
CertificateEffectiveDate	12/19/2023
CertificateExpirationDate	12/18/2025
FacilityType	Waiver

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This page was last updated on: 4/23/2024