45D2033967 CLIA NUMBER - RAPHA MEDICAL CLINIC

Laboratory Demographics

  • CLIA Code: 45D2033967
  • Facility Name: RAPHA MEDICAL CLINIC
  • Facility Address: 3317 ALTA MESA BLVD
    FORT WORTH, TX
    ZIP 76133
  • Facility Phone: 817 292-2011
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: FERGUS AKWAR
  • NPI Number: 1548367766
  • Taxonomy: 207Q00000X - Family Medicine

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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
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 12/13/2023
Certificate Expiration Date 12/12/2025
Facility Type Physician Office
Lab Director FERGUS AKWAR

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