45D0926624 CLIA NUMBER - NORTHEAST FORT WORTH DIALYSIS CENTER

Laboratory Demographics

  • CLIA Code: 45D0926624
  • Facility Name: NORTHEAST FORT WORTH DIALYSIS CENTER
  • Facility Address: 4121 DENTON HIGHWAY
    HALTOM CITY, TX
    ZIP 76117
  • Facility Phone: 817 581-1515
  • Facility Type: End Stage Renal Disease Dialysis Facility
  • Facility Type: Waiver
  • Lab Director: ABDUL HAFEEZ
  • NPI Number: 1841302726
  • Taxonomy: 261QE0700X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 45D0926624
LAB Type End Stage Renal Disease Dialysis Facility
Facility Name NORTHEAST FORT WORTH DIALYSIS CENTER
Street 4121 DENTON HIGHWAY
City HALTOM CITY
State TX
ZIP 76117
Phone 817 581-1515
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 3/27/2025
Certificate Expiration Date 3/26/2027
Facility Type End Stage Renal Disease Dialysis Facility
Lab Director ABDUL HAFEEZ

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This page was last updated on: 3/20/2025