45D0895512 CLIA NUMBER - MARY MILAM MD, PA

Laboratory Demographics

  • CLIA Code: 45D0895512
  • Facility Name: MARY MILAM MD, PA
  • Facility Address: 1307 8TH AVENUE SUITE 205
    FORT WORTH, TX
    ZIP 76104
  • Facility Phone: 817 924-4300
  • Facility Type: Physician Office
  • Facility Type: Certificate of Compliance
  • Lab Director: MARY MILAM
  • NPI Number: 1174786933
  • Taxonomy: 207RH0003X - Internal Medicine

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CLIA Record

Field Name Field Value
CLIA Number 45D0895512
LAB Type Physician Office
Facility Name MARY MILAM MD, PA
Street 1307 8TH AVENUE SUITE 205
City FORT WORTH
State TX
ZIP 76104
Phone 817 924-4300
Certificate Type Certificate of Compliance
Certificate Type Description This certificate is issued to a laboratory after an inspection that finds the laboratory to be in compliance with all applicable CLIA requirements.
Certificate Effective Date 3/17/2025
Certificate Expiration Date 3/16/2027
Facility Type Physician Office
Lab Director MARY MILAM

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