45D1054780 CLIA NUMBER - HEALTH IMAGING PARTNERS, LLC DBA ENVISION IMAGING AT PENNSYLVANIA

Laboratory Demographics

  • CLIA Code: 45D1054780
  • Facility Name: HEALTH IMAGING PARTNERS, LLC DBA ENVISION IMAGING AT PENNSYLVANIA
  • Facility Address: 1101 PENNSYLVANIA AVE SUITE 101
    FORT WORTH, TX
    ZIP 76104
  • Facility Phone: 817 321-0300
  • Facility Type: Other - IDTF-DIAGNOSTIC RADIOLOGY
  • Facility Type: Waiver
  • Lab Director: STACY REYES
  • NPI Number: 1396166039
  • Taxonomy: 293D00000X - Physiological Laboratory

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CLIA Record

Field Name Field Value
CLIA Number 45D1054780
LAB Type Other - IDTF-DIAGNOSTIC RADIOLOGY
Facility Name HEALTH IMAGING PARTNERS, LLC DBA ENVISION IMAGING AT PENNSYLVANIA
Street 1101 PENNSYLVANIA AVE SUITE 101
City FORT WORTH
State TX
ZIP 76104
Phone 817 321-0300
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 1/11/2025
Certificate Expiration Date 1/10/2027
Facility Type Other - IDTF-DIAGNOSTIC RADIOLOGY
Lab Director STACY REYES

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