45D2303179 CLIA NUMBER - ELITE CARDIOVASCULAR GROUP PLLC

Laboratory Demographics

  • CLIA Code: 45D2303179
  • Facility Name: ELITE CARDIOVASCULAR GROUP PLLC
  • Facility Address: 2701 PRINCE GEORGE AVE STE 102
    DESOTO, TX
    ZIP 75115
  • Facility Phone: 972 572-1600
  • Facility Type: Ambulatory Surgery Center
  • Facility Type: Waiver
  • Lab Director: NIKHIL NALLURI
  • NPI Number: 1609532365
  • Taxonomy: 207RI0011X - Internal Medicine

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CLIA Record

Field Name Field Value
CLIA Number 45D2303179
LAB Type Ambulatory Surgery Center
Facility Name ELITE CARDIOVASCULAR GROUP PLLC
Street 2701 PRINCE GEORGE AVE STE 102
City DESOTO
State TX
ZIP 75115
Phone 972 572-1600
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 4/22/2024
Certificate Expiration Date 4/21/2026
Facility Type Ambulatory Surgery Center
Lab Director NIKHIL NALLURI

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