45D1093868 CLIA NUMBER - RUPA PACHIGOLLA, MD PSC

Laboratory Demographics

  • CLIA Code: 45D1093868
  • Facility Name: RUPA PACHIGOLLA, MD PSC
  • Facility Address: 2016 FORT WORTH HIGHWAY
    WEATHERFORD, TX
    ZIP 76086
  • Facility Phone: 817 596-8637
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: RUPA PACHIGOLLA
  • NPI Number: 1639165731
  • Taxonomy: 207Q00000X - Family Medicine

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CLIA Record

Field Name Field Value
CLIA Number 45D1093868
LAB Type Physician Office
Facility Name RUPA PACHIGOLLA, MD PSC
Street 2016 FORT WORTH HIGHWAY
City WEATHERFORD
State TX
ZIP 76086
Phone 817 596-8637
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 1/5/2025
Certificate Expiration Date 1/4/2027
Facility Type Physician Office
Lab Director RUPA PACHIGOLLA

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