45D2322155 CLIA NUMBER - PROMED HEALTH PLLC

Laboratory Demographics

  • CLIA Code: 45D2322155
  • Facility Name: PROMED HEALTH PLLC
  • Facility Address: 11691 INDEPENDENCE PKWY STE 110
    FRISCO, TX
    ZIP 75035
  • Facility Phone: 945 221-6442
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: KAVITHA ILAYARAJA
  • NPI Number: 1487471967
  • Taxonomy: 207R00000X - Internal Medicine

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CLIA Record

Field Name Field Value
CLIA Number 45D2322155
LAB Type Physician Office
Facility Name PROMED HEALTH PLLC
Street 11691 INDEPENDENCE PKWY STE 110
City FRISCO
State TX
ZIP 75035
Phone 945 221-6442
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 4/16/2025
Certificate Expiration Date 4/15/2027
Facility Type Physician Office
Lab Director KAVITHA ILAYARAJA

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