45D1025217 CLIA NUMBER - COOPER STREET MEDICAL CLINIC

Laboratory Demographics

  • CLIA Code: 45D1025217
  • Facility Name: COOPER STREET MEDICAL CLINIC
  • Facility Address: 2360 FM 157
    MANSFIELD, TX
    ZIP 76063
  • Facility Phone: 817 453-2123
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: BINDAL SAPAN
  • NPI Number: 1578618492
  • Taxonomy: 207Q00000X - Family Medicine

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CLIA Record

Field Name Field Value
CLIA Number 45D1025217
LAB Type Physician Office
Facility Name COOPER STREET MEDICAL CLINIC
Street 2360 FM 157
City MANSFIELD
State TX
ZIP 76063
Phone 817 453-2123
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 5/3/2024
Certificate Expiration Date 5/2/2026
Facility Type Physician Office
Lab Director BINDAL SAPAN

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