45D2080102 CLIA NUMBER - IHP - LIVINGWELL HEALTH SOLUTIONS CLINIC

Laboratory Demographics

  • CLIA Code: 45D2080102
  • Facility Name: IHP - LIVINGWELL HEALTH SOLUTIONS CLINIC
  • Facility Address: 4700 MARINE CREEK PARKWAY
    FORT WORTH, TX
    ZIP 76179
  • Facility Phone: 817 234-6973
  • Facility Type: Other - WORKSITE HLTH MED CLINIC
  • Facility Type: Waiver
  • Lab Director: AMI H. KHATRI
  • NPI Number: 1275914079
  • Taxonomy: 208D00000X - General Practice

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CLIA Record

Field Name Field Value
CLIA Number 45D2080102
LAB Type Other - WORKSITE HLTH MED CLINIC
Facility Name IHP - LIVINGWELL HEALTH SOLUTIONS CLINIC
Street 4700 MARINE CREEK PARKWAY
City FORT WORTH
State TX
ZIP 76179
Phone 817 234-6973
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 6/30/2024
Certificate Expiration Date 6/29/2026
Facility Type Other - WORKSITE HLTH MED CLINIC
Lab Director AMI H. KHATRI

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