45D1081419 CLIA NUMBER - LOGOS HEALTHCARE SERVICES

Laboratory Demographics

  • CLIA Code: 45D1081419
  • Facility Name: LOGOS HEALTHCARE SERVICES
  • Facility Address: 528 E MAIN STREET
    RICHARDSON, TX
    ZIP 75081
  • Facility Phone: 214 861-8080
  • Facility Type: End Stage Renal Disease Dialysis Facility
  • Facility Type: Waiver
  • Lab Director: MOBOLAJI IKUJENYO
  • NPI Number: 1669659140
  • Taxonomy: 3747P1801X - Technician

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CLIA Record

Field Name Field Value
CLIA Number 45D1081419
LAB Type End Stage Renal Disease Dialysis Facility
Facility Name LOGOS HEALTHCARE SERVICES
Street 528 E MAIN STREET
City RICHARDSON
State TX
ZIP 75081
Phone 214 861-8080
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 3/17/2024
Certificate Expiration Date 3/16/2026
Facility Type End Stage Renal Disease Dialysis Facility
Lab Director MOBOLAJI IKUJENYO

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This page was last updated on: 6/4/2025