45D2318527 CLIA NUMBER - MY CARE FAMILY & WELLNESS CLINIC

Laboratory Demographics

  • CLIA Code: 45D2318527
  • Facility Name: MY CARE FAMILY & WELLNESS CLINIC
  • Facility Address: 2707 BOLTON BOONE DR SUITE 102
    DESOTO, TX
    ZIP 75115
  • Facility Phone: 469 530-4990
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: DAMIAN IRABOR
  • NPI Number: 1255950002
  • Taxonomy: 207Q00000X - Family Medicine

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CLIA Record

Field Name Field Value
CLIA Number 45D2318527
LAB Type Physician Office
Facility Name MY CARE FAMILY & WELLNESS CLINIC
Street 2707 BOLTON BOONE DR SUITE 102
City DESOTO
State TX
ZIP 75115
Phone 469 530-4990
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 2/12/2025
Certificate Expiration Date 2/11/2027
Facility Type Physician Office
Lab Director DAMIAN IRABOR

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