45D2014206 CLIA NUMBER - BASANTI VRUSHAB MD

Laboratory Demographics

  • CLIA Code: 45D2014206
  • Facility Name: BASANTI VRUSHAB MD
  • Facility Address: 1615 PRECINCT LINE RD SUITE 103
    HURST, TX
    ZIP 76054
  • Facility Phone: 817 281-4910
  • Facility Type: Physician Office
  • Facility Type: Microscopy
  • Lab Director: BASANTI B. VRUSHAB
  • NPI Number: 1265436943
  • Taxonomy: 207R00000X - Internal Medicine

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CLIA Record

Field Name Field Value
CLIA Number 45D2014206
LAB Type Physician Office
Facility Name BASANTI VRUSHAB MD
Street 1615 PRECINCT LINE RD SUITE 103
City HURST
State TX
ZIP 76054
Phone 817 281-4910
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 10/4/2024
Certificate Expiration Date 10/3/2026
Facility Type Physician Office
Lab Director BASANTI B. VRUSHAB

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