45D0863388 CLIA NUMBER - WILLIAM F COTHERN DO PA

Laboratory Demographics

  • CLIA Code: 45D0863388
  • Facility Name: WILLIAM F COTHERN DO PA
  • Facility Address: 4201 CAMP BOWIE BOULEVARD SUITE A
    FORT WORTH, TX
    ZIP 76107
  • Facility Phone: 817 377-1243
  • Facility Type: Physician Office
  • Facility Type: Microscopy
  • Lab Director: WILLIAM F. COTHERN DO
  • NPI Number: 1467583294
  • Taxonomy: 1223G0001X - Dentist

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CLIA Record

Field Name Field Value
CLIA Number 45D0863388
LAB Type Physician Office
Facility Name WILLIAM F COTHERN DO PA
Street 4201 CAMP BOWIE BOULEVARD SUITE A
City FORT WORTH
State TX
ZIP 76107
Phone 817 377-1243
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 9/1/2024
Certificate Expiration Date 8/31/2026
Facility Type Physician Office
Lab Director WILLIAM F. COTHERN DO

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