45D2301415 CLIA NUMBER - PROSPECT PRIMARY CARE CLINIC

Laboratory Demographics

  • CLIA Code: 45D2301415
  • Facility Name: PROSPECT PRIMARY CARE CLINIC
  • Facility Address: 670 W ARAPAHO RD STE 4
    RICHARDSON, TX
    ZIP 75080
  • Facility Phone: 945 333-5481
  • Facility Type: Practitioner Other
  • Facility Type: Waiver
  • Lab Director: ELURI LORENA
  • NPI Number: 1073378915
  • Taxonomy: 363LA2200X - Nurse Practitioner

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CLIA Record

Field Name Field Value
CLIA Number 45D2301415
LAB Type Practitioner Other
Facility Name PROSPECT PRIMARY CARE CLINIC
Street 670 W ARAPAHO RD STE 4
City RICHARDSON
State TX
ZIP 75080
Phone 945 333-5481
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 3/26/2024
Certificate Expiration Date 3/25/2026
Facility Type Practitioner Other
Lab Director ELURI LORENA

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