45D1040044 CLIA NUMBER - LIFE CARE CENTER OF HALTOM

Laboratory Demographics

  • CLIA Code: 45D1040044
  • Facility Name: LIFE CARE CENTER OF HALTOM
  • Facility Address: 2936 MARKUM DRIVE
    FORT WORTH, TX
    ZIP 76117
  • Facility Phone: 817 831-0545
  • Facility Type: Skilled Nursing Facility/Nursing Facility
  • Facility Type: Waiver
  • Lab Director: CHARLES MAXVILL,DO
  • NPI Number: 1700802873
  • Taxonomy: 314000000X - Skilled Nursing Facility

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CLIA Record

Field Name Field Value
CLIA Number 45D1040044
LAB Type Skilled Nursing Facility/Nursing Facility
Facility Name LIFE CARE CENTER OF HALTOM
Street 2936 MARKUM DRIVE
City FORT WORTH
State TX
ZIP 76117
Phone 817 831-0545
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 4/28/2025
Certificate Expiration Date 4/27/2027
Facility Type Skilled Nursing Facility/Nursing Facility
Lab Director CHARLES MAXVILL,DO

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