45D2129162 CLIA NUMBER - HEART PLACE DBA FORT WORTH HEART, PA

Laboratory Demographics

  • CLIA Code: 45D2129162
  • Facility Name: HEART PLACE DBA FORT WORTH HEART, PA
  • Facility Address: 805 HILL BLVD STE 106
    GRANBURY, TX
    ZIP 76048
  • Facility Phone: 817 338-1300
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: SANJAY BHARGAVA
  • NPI Number: 1801939244
  • Taxonomy: 261QM2500X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 45D2129162
LAB Type Physician Office
Facility Name HEART PLACE DBA FORT WORTH HEART, PA
Street 805 HILL BLVD STE 106
City GRANBURY
State TX
ZIP 76048
Phone 817 338-1300
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 4/13/2025
Certificate Expiration Date 4/12/2027
Facility Type Physician Office
Lab Director SANJAY BHARGAVA

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