45D2170580 CLIA NUMBER - DENISE BRUCKERHOFF DO, PLLC DBA BRUCKERHOFF INTERNAL MEDICINE ASSOC

Laboratory Demographics

  • CLIA Code: 45D2170580
  • Facility Name: DENISE BRUCKERHOFF DO, PLLC DBA BRUCKERHOFF INTERNAL MEDICINE ASSOC
  • Facility Address: 1900 MATLOCK RD BUILDING 6 SUITE 604
    MANSFIELD, TX
    ZIP 76063
  • Facility Phone: (817) 755-1005
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: DENISE K. BRUCKERHOFF
  • NPI Number: 1164690111
  • Taxonomy: 207R00000X - Internal Medicine

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CLIA Record

Field Name Field Value
CLIA Number 45D2170580
LAB Type Physician Office
Facility Name DENISE BRUCKERHOFF DO, PLLC DBA BRUCKERHOFF INTERNAL MEDICINE ASSOC
Street 1900 MATLOCK RD BUILDING 6 SUITE 604
City MANSFIELD
State TX
ZIP 76063
Phone 8177551005
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 8/14/2025
Certificate Expiration Date 8/13/2027
Facility Type Physician Office
Lab Director DENISE K. BRUCKERHOFF

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This page was last updated on: 5/18/2026