45D1001257 CLIA NUMBER - CONCENTRA URGENT CARE - FOSSIL CREEK

Laboratory Demographics

  • CLIA Code: 45D1001257
  • Facility Name: CONCENTRA URGENT CARE - FOSSIL CREEK
  • Facility Address: 4060 SAND SHELL DRIVE
    FORT WORTH, TX
    ZIP 76137
  • Facility Phone: 817 306-9777
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: GEORGE NIEMIROWSKI
  • NPI Number: 1457500407
  • Taxonomy: 261QH0100X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 45D1001257
LAB Type Physician Office
Facility Name CONCENTRA URGENT CARE - FOSSIL CREEK
Street 4060 SAND SHELL DRIVE
City FORT WORTH
State TX
ZIP 76137
Phone 817 306-9777
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 7/5/2024
Certificate Expiration Date 7/4/2026
Facility Type Physician Office
Lab Director GEORGE NIEMIROWSKI

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