45D0486963 CLIA NUMBER - WEDGEWOOD FAMILY HEALTH ASSOCS

Laboratory Demographics

  • CLIA Code: 45D0486963
  • Facility Name: WEDGEWOOD FAMILY HEALTH ASSOCS
  • Facility Address: 5703 WESTCREEK DR
    FORT WORTH, TX
    ZIP 76133
  • Facility Phone: 817 294-0731
  • Facility Type: Physician Office
  • Facility Type: Microscopy
  • Lab Director: AL E. FAIGIN
  • NPI Number: 1174575625
  • Taxonomy: 314000000X - Skilled Nursing Facility

Map and Directions

Get Directions

CLIA Record

Field Name Field Value
CLIA Number 45D0486963
LAB Type Physician Office
Facility Name WEDGEWOOD FAMILY HEALTH ASSOCS
Street 5703 WESTCREEK DR
City FORT WORTH
State TX
ZIP 76133
Phone 817 294-0731
Certificate Type Certificate for Provider-Performed Microscopy Procedures (PPMP)
Certificate Type Description This certificate is issued to a laboratory in which a physician, midlevel practitioner or dentist performs no tests other than the microscopy procedures. This certificate permits the laboratory to also perform waived tests.
Certificate Effective Date 4/12/2025
Certificate Expiration Date 4/11/2027
Facility Type Physician Office
Lab Director AL E. FAIGIN

Download Record

Download this CLIA record record in Text format: Export

Download this CLIA record record in Excel (CSV) format: Export

Download this CLIA record record in XML format: Export

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