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LIFEGENIX MED PLLC
NPI 1689473068
Orthopaedic Surgery - Sports Medicine in Dallas, TX

Active since March 10, 2025CLIA 45D2314553 · Waiver
17230 DALLAS PKWY STE 110, DALLAS, TX 75248(972) 236-3333(972) 920-3754 Get Directions Write a Review

NPPES record last updated: March 10, 2025. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Lifegenix Med Pllc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

LIFEGENIX MED PLLC (NPI 1689473068) is a healthcare organization registered as a sports medicine in Dallas, Texas and active in the NPI registry since March 2025. The organization holds a CLIA Waiver certificate valid through November 20, 2026 and lists Laurie Clemons, Vp Of Operations, as its authorized official.

NPPES Registry Identity

NPI1689473068
Entity TypeOrganization
Primary Taxonomy207XX0005X
Legal Business NameLIFEGENIX MED PLLC
Location Address17230 DALLAS PKWY STE 110Dallas, TX 75248-1136
Mailing Address17230 Dallas Pkwy Ste 110Dallas, TX 75248-1136 · (972) 236-3333 · Fax (972) 920-3754
Phone(972) 236-3333
Fax(972) 920-3754
Organization SubpartNo
Authorized OfficialLaurie ClemonsVp Of Operations · (972) 236-3333
Enumeration DateMarch 10, 2025
NPPES CertifiedMarch 10, 2025
✔ NPI 1689473068 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyOrthopaedic Surgery · Sports MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207XX0005X
Definition
An orthopaedic surgeon trained in sports medicine provides appropriate care for all structures of the musculoskeletal system directly affected by participation in sporting activity. This specialist is proficient in areas including conditioning, training and fitness, athletic performance and the impact of dietary supplements, pharmaceuticals, and nutrition on performance and health, coordination of care within the team setting utilizing other health care professionals, field evaluation and management, soft tissue biomechanics and injury healing and repair. Knowledge and understanding of the principles and techniques of rehabilitation, athletic equipment and orthotic devices enables the specialist to prevent and manage athletic injuries.
Also ListedOrthopaedic SurgeryTaxonomy 207X00000X
17230 DALLAS PKWY STE 110, Dallas, TX 75248
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Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 45D2314553

Lifegenix Med, PLLC · Dallas, TX
Active · expires Nov 20, 2026
CLIA Number45D2314553
Laboratory TypeHealth Main. Organization
Certificate Effective DateNovember 21, 2024
Certificate Expiration DateNovember 20, 2026
Laboratory DirectorKarla Beard
Laboratory Phone(972) 236-3333
Laboratory LocationLifegenix Med, PLLC17230 Dallas Parkway, Dallas, TX 75248
CLIA data matches this NPI record on: Address Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Lifegenix Med PLLC's NPI number?

The NPI number for Lifegenix Med PLLC is 1689473068. It was assigned to this organization in the NPPES registry on March 10, 2025.

Where is Lifegenix Med PLLC located?

Lifegenix Med PLLC is located at 17230 Dallas Pkwy Ste 110, Dallas, TX 75248. The listed phone number is (972) 236-3333.

What is Lifegenix Med PLLC's specialty?

The primary specialty registered for this NPI is Orthopaedic Surgery, specializing in Sports Medicine, with taxonomy code 207XX0005X.

Does Lifegenix Med PLLC hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 45D2314553) is associated with this NPI, valid through November 20, 2026. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Lifegenix Med PLLC was last updated on March 10, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 17 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.