45D0486084 CLIA NUMBER - TEXAS DIGESTIVE DISEASE CONSULTANT

Laboratory Demographics

  • CLIA Code: 45D0486084
  • Facility Name: TEXAS DIGESTIVE DISEASE CONSULTANT
  • Facility Address: 6317 HARRIS PARKWAY, SUITE 300
    FORT WORTH, TX
    ZIP 76132
  • Facility Phone: 817 361-6900
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: THOMAS N. DEWAR
  • NPI Number: 1053818344
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 45D0486084
LAB Type Physician Office
Facility Name TEXAS DIGESTIVE DISEASE CONSULTANT
Street 6317 HARRIS PARKWAY, SUITE 300
City FORT WORTH
State TX
ZIP 76132
Phone 817 361-6900
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 9/1/2024
Certificate Expiration Date 8/31/2026
Facility Type Physician Office
Lab Director THOMAS N. DEWAR

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