45D0976202 CLIA NUMBER - JENNIFER C BROOKS MD

Laboratory Demographics

  • CLIA Code: 45D0976202
  • Facility Name: JENNIFER C BROOKS MD
  • Facility Address: 1001 12TH AVENUE , SUITE 150
    FORT WORTH, TX
    ZIP 76104
  • Facility Phone: 817 334-0562
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: JENNIFER C. BROOKS MD
  • NPI Number: 1346651999
  • Taxonomy: 207Q00000X - Family Medicine

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CLIA Record

Field Name Field Value
CLIA Number 45D0976202
LAB Type Physician Office
Facility Name JENNIFER C BROOKS MD
Street 1001 12TH AVENUE , SUITE 150
City FORT WORTH
State TX
ZIP 76104
Phone 817 334-0562
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 7/27/2024
Certificate Expiration Date 7/26/2026
Facility Type Physician Office
Lab Director JENNIFER C. BROOKS MD

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