45D0990121 CLIA NUMBER - HEART PLACE BEDFORD

Laboratory Demographics

  • CLIA Code: 45D0990121
  • Facility Name: HEART PLACE BEDFORD
  • Facility Address: 1604 HOSPITAL PARKWAY SUITE 301
    BEDFORD, TX
    ZIP 76022
  • Facility Phone: 972 391-1915
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: ALI MOUSTAPHA
  • NPI Number: 1245490747
  • Taxonomy: 207RC0000X - Internal Medicine

Map and Directions

Get Directions

CLIA Record

Field Name Field Value
CLIA Number 45D0990121
LAB Type Physician Office
Facility Name HEART PLACE BEDFORD
Street 1604 HOSPITAL PARKWAY SUITE 301
City BEDFORD
State TX
ZIP 76022
Phone 972 391-1915
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 8/14/2023
Certificate Expiration Date 8/13/2025
Facility Type Physician Office
Lab Director ALI MOUSTAPHA

Download Record

Download this CLIA record record in Text format: Export

Download this CLIA record record in Excel (CSV) format: Export

Download this CLIA record record in XML format: Export

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