CLIA lab
CLIA 45D1050926: Old Town Family Practice
Coppell, TX. Certificate and address details from the CMS Provider of Services file for clinical laboratories.
CLIA number 45D1050926 belongs to Old Town Family Practice in Coppell, TX.
Certificate of Waiver, effective February 15, 2026, expires February 14, 2028.
Active in the CMS Provider of Services file posted October 16, 2026.
Source: CMS Provider of Services File, Clinical Laboratories (CLIA), as of October 16, 2026. Publisher page
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Certificate
- Certificate type
- Certificate of Waiver
- Certificate effective
- February 15, 2026
- Certificate expiration
- February 14, 2028
- Status in the CMS file
- Active (termination code 00)
- Original participation date
- February 15, 2006
- Facility type
- Physician office
- Ownership (control type)
- Proprietary
- Lab classification
- CLIA laboratory
Source: CMS Provider of Services File, Clinical Laboratories (CLIA), as of October 16, 2026. Publisher page
Lab and contact
- CLIA number
- 45D1050926
- Lab name
- Old Town Family Practice
- Address
- 413 W Bethel Road, Suite 300, Coppell, TX 75019
- Phone
- (972) 393-4726
- Fax
- (972) 393-5313
Annual test volume the lab reported
- Waived tests
- 300
Volumes are what the lab reported to CMS on its CMS-116 application, as carried in the file.
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Related
Questions
What is the CLIA number for Old Town Family Practice in Coppell?
45D1050926, per the CMS Provider of Services file posted October 16, 2026.
What CLIA certificate does Old Town Family Practice hold?
A Certificate of Waiver, according to the CMS file.
When does CLIA 45D1050926 expire?
The CMS file lists February 14, 2028 as the certificate expiration date; the certificate took effect February 15, 2026.