45D2148001 CLIA NUMBER - MEDI CARE CLINICS PLLC

Laboratory Demographics

  • CLIA Code: 45D2148001
  • Facility Name: MEDI CARE CLINICS PLLC
  • Facility Address: 9557 N BEACH STREET STE 121-C
    FORT WORTH, TX
    ZIP 76244
  • Facility Phone: 817 741-5050
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: PHILIP B. HAMBY
  • NPI Number: 1992165393
  • Taxonomy: 363LF0000X - Nurse Practitioner

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CLIA Record

Field Name Field Value
CLIA Number 45D2148001
LAB Type Physician Office
Facility Name MEDI CARE CLINICS PLLC
Street 9557 N BEACH STREET STE 121-C
City FORT WORTH
State TX
ZIP 76244
Phone 817 741-5050
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 5/2/2024
Certificate Expiration Date 5/1/2026
Facility Type Physician Office
Lab Director PHILIP B. HAMBY

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