45D1031978 CLIA NUMBER - COOK CHILDREN'S URGENT CARE FORT WORTH

Laboratory Demographics

  • CLIA Code: 45D1031978
  • Facility Name: COOK CHILDREN'S URGENT CARE FORT WORTH
  • Facility Address: 1401 W PULASKI
    FORT WORTH, TX
    ZIP 76104
  • Facility Phone: 682 885-4296
  • Facility Type: Ancillary Testing Site in Health Care Center
  • Facility Type: Waiver
  • Lab Director: STACEY A. BERRY
  • NPI Number: 1467903088
  • Taxonomy: 208000000X - Pediatrics

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CLIA Record

Field Name Field Value
CLIA Number 45D1031978
LAB Type Ancillary Testing Site in Health Care Center
Facility Name COOK CHILDREN'S URGENT CARE FORT WORTH
Street 1401 W PULASKI
City FORT WORTH
State TX
ZIP 76104
Phone 682 885-4296
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 5/7/2025
Certificate Expiration Date 5/6/2027
Facility Type Ancillary Testing Site in Health Care Center
Lab Director STACEY A. BERRY

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