45D2322833 CLIA NUMBER - INTEGRATIVE MEDICAL OF DFW

Laboratory Demographics

  • CLIA Code: 45D2322833
  • Facility Name: INTEGRATIVE MEDICAL OF DFW
  • Facility Address: 670 N MCARTHUR BLVD SUITE 100
    COPPELL, TX
    ZIP 75019
  • Facility Phone: 972 745-4446
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: CHOUDARY JAGARLAMUDI
  • NPI Number: 1124554746
  • Taxonomy: 207R00000X - Internal Medicine

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CLIA Record

Field Name Field Value
CLIA Number 45D2322833
LAB Type Physician Office
Facility Name INTEGRATIVE MEDICAL OF DFW
Street 670 N MCARTHUR BLVD SUITE 100
City COPPELL
State TX
ZIP 75019
Phone 972 745-4446
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 4/28/2025
Certificate Expiration Date 4/27/2027
Facility Type Physician Office
Lab Director CHOUDARY JAGARLAMUDI

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