45D2142786 CLIA NUMBER - DPC HEALTHCARE

Laboratory Demographics

  • CLIA Code: 45D2142786
  • Facility Name: DPC HEALTHCARE
  • Facility Address: 4561 HERITAGE TRACE PARKWAY SUITE 109
    FORT WORTH, TX
    ZIP 76244
  • Facility Phone: 682 200-0035
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: TRAN NGUYEN
  • NPI Number: 1326661703
  • Taxonomy: 261QP2300X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 45D2142786
LAB Type Physician Office
Facility Name DPC HEALTHCARE
Street 4561 HERITAGE TRACE PARKWAY SUITE 109
City FORT WORTH
State TX
ZIP 76244
Phone 682 200-0035
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 9/12/2024
Certificate Expiration Date 9/11/2026
Facility Type Physician Office
Lab Director TRAN NGUYEN

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