45D2310239 CLIA NUMBER - FAMILY CARE MEDICAL CENTER

Laboratory Demographics

  • CLIA Code: 45D2310239
  • Facility Name: FAMILY CARE MEDICAL CENTER
  • Facility Address: 3464 WEBB CHAPEL EXTENSION
    DALLAS, TX
    ZIP 75220
  • Facility Phone: 469 501-6910
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: GUILLERMO M. FUENTES
  • NPI Number: 1659541621
  • Taxonomy: 332B00000X - Durable Medical Equipment & Medical Supplies

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CLIA Record

Field Name Field Value
CLIA Number 45D2310239
LAB Type Physician Office
Facility Name FAMILY CARE MEDICAL CENTER
Street 3464 WEBB CHAPEL EXTENSION
City DALLAS
State TX
ZIP 75220
Phone 469 501-6910
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 8/29/2024
Certificate Expiration Date 8/28/2026
Facility Type Physician Office
Lab Director GUILLERMO M. FUENTES

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