45D0895878 CLIA NUMBER - UNIVERSAL HEALTH SERVICES

Laboratory Demographics

  • CLIA Code: 45D0895878
  • Facility Name: UNIVERSAL HEALTH SERVICES
  • Facility Address: 1208 COUNTRY CLUB LANE
    FORT WORTH, TX
    ZIP 76112
  • Facility Phone: 817 451-1404
  • Facility Type: Home Health Agency
  • Facility Type: Waiver
  • Lab Director: KATHY D. WALLS
  • NPI Number: 1700165123
  • Taxonomy: 253Z00000X - In Home Supportive Care

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CLIA Record

Field Name Field Value
CLIA Number 45D0895878
LAB Type Home Health Agency
Facility Name UNIVERSAL HEALTH SERVICES
Street 1208 COUNTRY CLUB LANE
City FORT WORTH
State TX
ZIP 76112
Phone 817 451-1404
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 12/20/2024
Certificate Expiration Date 12/19/2026
Facility Type Home Health Agency
Lab Director KATHY D. WALLS

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