CLIA lab
CLIA 45D2163869: Idtc Clinical Laboratory
Grand Prairie, TX. Certificate and address details from the CMS Provider of Services file for clinical laboratories.
CLIA number 45D2163869 belongs to Idtc Clinical Laboratory in Grand Prairie, TX.
Certificate of Waiver, effective June 29, 2026, expires June 28, 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
- June 29, 2026
- Certificate expiration
- June 28, 2028
- Status in the CMS file
- Active (termination code 00)
- Original participation date
- March 22, 2019
- Facility type
- School or student health service
- 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
- 45D2163869
- Lab name
- Idtc Clinical Laboratory
- Address
- 410 NW 11th St Suite 112, Grand Prairie, TX 75050
- Phone
- (469) 299-8974
- Fax
- (469) 480-4763
Annual test volume the lab reported
- Waived tests
- 60,000
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 Idtc Clinical Laboratory in Grand Prairie?
45D2163869, per the CMS Provider of Services file posted October 16, 2026.
What CLIA certificate does Idtc Clinical Laboratory hold?
A Certificate of Waiver, according to the CMS file.
When does CLIA 45D2163869 expire?
The CMS file lists June 28, 2028 as the certificate expiration date; the certificate took effect June 29, 2026.