45D2146784 CLIA NUMBER - USRC WEST FORK LLC DBA US RENAL CARE WEST FORK DIALYSIS

Laboratory Demographics

  • CLIA Code: 45D2146784
  • Facility Name: USRC WEST FORK LLC DBA US RENAL CARE WEST FORK DIALYSIS
  • Facility Address: 725 N INDUSTRIAL BLVD SUITE 100
    BEDFORD, TX
    ZIP 76021
  • Facility Phone: 817 358-4544
  • Facility Type: End Stage Renal Disease Dialysis Facility
  • Facility Type: Waiver
  • Lab Director: SARAVANAN BALAMUTHUSAMY
  • NPI Number: 1881195576
  • Taxonomy: 261QE0700X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 45D2146784
LAB Type End Stage Renal Disease Dialysis Facility
Facility Name USRC WEST FORK LLC DBA US RENAL CARE WEST FORK DIALYSIS
Street 725 N INDUSTRIAL BLVD SUITE 100
City BEDFORD
State TX
ZIP 76021
Phone 817 358-4544
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 4/5/2024
Certificate Expiration Date 4/4/2026
Facility Type End Stage Renal Disease Dialysis Facility
Lab Director SARAVANAN BALAMUTHUSAMY

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