45D0976093 CLIA NUMBER - RENAL CENTER OF FORT WORTH

Laboratory Demographics

  • CLIA Code: 45D0976093
  • Facility Name: RENAL CENTER OF FORT WORTH
  • Facility Address: 251 UNIVERSITY DRIVE SUITE 101
    FORT WORTH, TX
    ZIP 76107
  • Facility Phone: 817 870-5002
  • Facility Type: End Stage Renal Disease Dialysis Facility
  • Facility Type: Waiver
  • Lab Director: RAGHUVEER VANGURU
  • NPI Number: 1568487585
  • Taxonomy: 261QE0700X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 45D0976093
LAB Type End Stage Renal Disease Dialysis Facility
Facility Name RENAL CENTER OF FORT WORTH
Street 251 UNIVERSITY DRIVE SUITE 101
City FORT WORTH
State TX
ZIP 76107
Phone 817 870-5002
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 7/25/2024
Certificate Expiration Date 7/24/2026
Facility Type End Stage Renal Disease Dialysis Facility
Lab Director RAGHUVEER VANGURU

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