45D2033967 CLIA NUMBER - RAPHA MEDICAL CLINIC

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Laboratory Demographics

CLIA Number: 45D2033967

Facility Name: RAPHA MEDICAL CLINIC

Facility Address:
3317 ALTA MESA BLVD
FORT WORTH, TX
ZIP 76133
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Facility Phone Number: 817 292-2011

Facility Type: Physician Office

Certificate Type: Waiver

NPI Number: 1548367766

Taxonomy: 207Q00000X - Family Medicine
Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.

CLIA Record

Field Name	Field Value
CLIA Number	45D2033967
LAB Type	Physician Office
Facility Name	RAPHA MEDICAL CLINIC
Street	3317 ALTA MESA BLVD
City	FORT WORTH
State	TX
ZIP	76133
Phone	817 292-2011
CertificateType	4
CertificateEffectiveDate	12/13/2023
CertificateExpirationDate	12/12/2025
FacilityType	Waiver

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