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45D1085282 CLIA NUMBER - SOUTHWESTERN BAPTIST THEOLOGICAL SEMINARY- SWBTS CLINIC

Laboratory Demographics

CLIA Number: 45D1085282

Facility Name: SOUTHWESTERN BAPTIST THEOLOGICAL SEMINARY- SWBTS CLINIC

Facility Address:
4501 STANLEY AVE
FORT WORTH, TX
ZIP 76115
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Facility Phone Number: 817 921-8880

Facility Type: School/Student Health Service

Certificate Type: Waiver
NPI Number: 1790013787

Taxonomy: 261Q00000X - Clinic/Center
A facility or distinct part of one used for the diagnosis and treatment of outpatients. Clinic/Center is irregularly defined, sometimes being limited to organizations serving specialized treatment requirements or distinct patient/client groups (e.g., radiology, poor, and public health).

CLIA Record

Field Name Field Value
CLIA Number 45D1085282
LAB Type School/Student Health Service
Facility Name SOUTHWESTERN BAPTIST THEOLOGICAL SEMINARY- SWBTS CLINIC
Street 4501 STANLEY AVE
City FORT WORTH
State TX
ZIP 76115
Phone 817 921-8880
CertificateType 4
CertificateEffectiveDate 6/13/2022
CertificateExpirationDate 6/12/2024
FacilityType Waiver

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This page was last updated on: 4/23/2024