45D1017853 CLIA NUMBER - DELTA MEDICAL PA KOFOWOROLA EKADI

Laboratory Demographics

  • CLIA Code: 45D1017853
  • Facility Name: DELTA MEDICAL PA KOFOWOROLA EKADI
  • Facility Address: 12001 S FREEWAY #210
    BURLESON, TX
    ZIP 76028
  • Facility Phone: (817) 293-8797
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: KOFOWOROLA EKADI
  • NPI Number: 1073550919
  • Taxonomy: 207R00000X - Internal Medicine

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CLIA Record

Field Name Field Value
CLIA Number 45D1017853
LAB Type Physician Office
Facility Name DELTA MEDICAL PA KOFOWOROLA EKADI
Street 12001 S FREEWAY #210
City BURLESON
State TX
ZIP 76028
Phone 8172938797
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 1/15/2026
Certificate Expiration Date 1/14/2028
Facility Type Physician Office
Lab Director KOFOWOROLA EKADI

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This page was last updated on: 5/18/2026