45D0948775 CLIA NUMBER - TEXAS CENTERS FOR INFECTIOUS DISEASE ASSOCIATES

Laboratory Demographics

  • CLIA Code: 45D0948775
  • Facility Name: TEXAS CENTERS FOR INFECTIOUS DISEASE ASSOCIATES
  • Facility Address: 1025 COLLEGE AVE
    FORT WORTH, TX
    ZIP 76104
  • Facility Phone: 817 810-9810
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: CEDRIC SPAK
  • NPI Number: 1750332441
  • Taxonomy: 207RI0200X - Internal Medicine

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CLIA Record

Field Name Field Value
CLIA Number 45D0948775
LAB Type Physician Office
Facility Name TEXAS CENTERS FOR INFECTIOUS DISEASE ASSOCIATES
Street 1025 COLLEGE AVE
City FORT WORTH
State TX
ZIP 76104
Phone 817 810-9810
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 7/20/2024
Certificate Expiration Date 7/19/2026
Facility Type Physician Office
Lab Director CEDRIC SPAK

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This page was last updated on: 6/4/2025