45D2316239 CLIA NUMBER - REVIVED HANDS LLC

Laboratory Demographics

  • CLIA Code: 45D2316239
  • Facility Name: REVIVED HANDS LLC
  • Facility Address: 2220 GUS THOMASSON RD, BUILDING B SUITE E
    MESQUITE, TX
    ZIP 75150
  • Facility Phone: 469 928-9141
  • Facility Type: Home Health Agency
  • Facility Type: Waiver
  • Lab Director: CHINECHEREM G. EGBUDIWE
  • NPI Number: 1750139655
  • Taxonomy: 251E00000X - Home Health

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CLIA Record

Field Name Field Value
CLIA Number 45D2316239
LAB Type Home Health Agency
Facility Name REVIVED HANDS LLC
Street 2220 GUS THOMASSON RD, BUILDING B SUITE E
City MESQUITE
State TX
ZIP 75150
Phone 469 928-9141
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 12/31/2024
Certificate Expiration Date 12/30/2026
Facility Type Home Health Agency
Lab Director CHINECHEREM G. EGBUDIWE

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