45D1065507 CLIA NUMBER - DARREN LACKAN MD PA

Laboratory Demographics

  • CLIA Code: 45D1065507
  • Facility Name: DARREN LACKAN MD PA
  • Facility Address: 6844 HARRIS PARKWAY SUITE 300L
    FORT WORTH, TX
    ZIP 76132
  • Facility Phone: 817 644-3801
  • Facility Type: Physician Office
  • Facility Type: Microscopy
  • Lab Director: DARREN W. LACKAN
  • NPI Number: 1871639757
  • Taxonomy: 207RE0101X - Internal Medicine

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CLIA Record

Field Name Field Value
CLIA Number 45D1065507
LAB Type Physician Office
Facility Name DARREN LACKAN MD PA
Street 6844 HARRIS PARKWAY SUITE 300L
City FORT WORTH
State TX
ZIP 76132
Phone 817 644-3801
Certificate Type Certificate for Provider-Performed Microscopy Procedures (PPMP)
Certificate Type Description This certificate is issued to a laboratory in which a physician, midlevel practitioner or dentist performs no tests other than the microscopy procedures. This certificate permits the laboratory to also perform waived tests.
Certificate Effective Date 7/12/2024
Certificate Expiration Date 7/11/2026
Facility Type Physician Office
Lab Director DARREN W. LACKAN

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