45D2088659 CLIA NUMBER - SGHPC-SA, LLC

Laboratory Demographics

  • CLIA Code: 45D2088659
  • Facility Name: SGHPC-SA, LLC
  • Facility Address: 2501 PARKVIEW DR SUITE 600A
    FORT WORTH, TX
    ZIP 76102
  • Facility Phone: 817 306-4545
  • Facility Type: Hospice
  • Facility Type: Waiver
  • Lab Director: JANICE L. MONTGOMERY
  • NPI Number: 1386062438
  • Taxonomy: 251G00000X - Hospice Care, Community Based

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CLIA Record

Field Name Field Value
CLIA Number 45D2088659
LAB Type Hospice
Facility Name SGHPC-SA, LLC
Street 2501 PARKVIEW DR SUITE 600A
City FORT WORTH
State TX
ZIP 76102
Phone 817 306-4545
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 12/16/2024
Certificate Expiration Date 12/15/2026
Facility Type Hospice
Lab Director JANICE L. MONTGOMERY

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