45D2078032 CLIA NUMBER - RAMIC FORT WORTH LLC

Laboratory Demographics

  • CLIA Code: 45D2078032
  • Facility Name: RAMIC FORT WORTH LLC
  • Facility Address: 750 12TH AVENUE, SUITE 100
    FORT WORTH, TX
    ZIP 76104
  • Facility Phone: 817 754-5220
  • Facility Type: Other - DIAGNOSTIC IMAGING
  • Facility Type: Waiver
  • Lab Director: ROCKY L. VIG
  • NPI Number: 1871788224
  • Taxonomy: 261QR0200X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 45D2078032
LAB Type Other - DIAGNOSTIC IMAGING
Facility Name RAMIC FORT WORTH LLC
Street 750 12TH AVENUE, SUITE 100
City FORT WORTH
State TX
ZIP 76104
Phone 817 754-5220
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 5/20/2024
Certificate Expiration Date 5/19/2026
Facility Type Other - DIAGNOSTIC IMAGING
Lab Director ROCKY L. VIG

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