45D2173400 CLIA NUMBER - TEXAS REGIONAL ASTHMA & ALLERGY CENTER

Laboratory Demographics

CLIA Number: 45D2173400

Facility Name: TEXAS REGIONAL ASTHMA & ALLERGY CENTER

Facility Address:
3349 GOLDEN TRIANGE BLVD
FORT WORTH, TX
ZIP 76177
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Facility Phone Number: 817 421-0770

Facility Type: Physician Office

Certificate Type: Microscopy

NPI Number: 1568545739

Taxonomy: 207KA0200X - Allergy & Immunology
A physician who specializes in the diagnosis, treatment, and management of allergies. Source: National Uniform Claim Committee

CLIA Record

Field Name	Field Value
CLIA Number	45D2173400
LAB Type	Physician Office
Facility Name	TEXAS REGIONAL ASTHMA & ALLERGY CENTER
Street	3349 GOLDEN TRIANGE BLVD
City	FORT WORTH
State	TX
ZIP	76177
Phone	817 421-0770
CertificateType	3
CertificateEffectiveDate	10/11/2023
CertificateExpirationDate	10/10/2025
FacilityType	PPMP

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This page was last updated on: 4/23/2024