45D2325695 CLIA NUMBER - ROADWAY PRIMARY CARE PLLC

Laboratory Demographics

  • CLIA Code: 45D2325695
  • Facility Name: ROADWAY PRIMARY CARE PLLC
  • Facility Address: 910 N DAVIS DR STE 100
    ARLINGTON, TX
    ZIP 76012
  • Facility Phone: 945 954-0574
  • Facility Type: Practitioner Other
  • Facility Type: Waiver
  • Lab Director: SHANTAU VALENTINE
  • NPI Number: 1851185433
  • Taxonomy: 363LA2200X - Nurse Practitioner

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CLIA Record

Field Name Field Value
CLIA Number 45D2325695
LAB Type Practitioner Other
Facility Name ROADWAY PRIMARY CARE PLLC
Street 910 N DAVIS DR STE 100
City ARLINGTON
State TX
ZIP 76012
Phone 945 954-0574
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 6/18/2025
Certificate Expiration Date 6/17/2027
Facility Type Practitioner Other
Lab Director SHANTAU VALENTINE

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