45D1027876 CLIA NUMBER - DAVID CORRAL, MD PA

Laboratory Demographics

  • CLIA Code: 45D1027876
  • Facility Name: DAVID CORRAL, MD PA
  • Facility Address: 6410 SOUTHWEST BLVD, STE 220
    FORT WORTH, TX
    ZIP 76109
  • Facility Phone: 817 377-9100
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: DAVID CORRAL
  • NPI Number: 1003846882
  • Taxonomy: 207R00000X - Internal Medicine

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CLIA Record

Field Name Field Value
CLIA Number 45D1027876
LAB Type Physician Office
Facility Name DAVID CORRAL, MD PA
Street 6410 SOUTHWEST BLVD, STE 220
City FORT WORTH
State TX
ZIP 76109
Phone 817 377-9100
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 8/3/2024
Certificate Expiration Date 8/2/2026
Facility Type Physician Office
Lab Director DAVID CORRAL

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