45D2177984 CLIA NUMBER - DIVINITY HOSPICE, LLC DBA DIVINITY HEALTHCARE

Laboratory Demographics

  • CLIA Code: 45D2177984
  • Facility Name: DIVINITY HOSPICE, LLC DBA DIVINITY HEALTHCARE
  • Facility Address: 5601 BRIDGE ST SUITE 504
    FORT WORTH, TX
    ZIP 76112
  • Facility Phone: 817 438-7463
  • Facility Type: Hospice
  • Facility Type: Waiver
  • Lab Director: BRENDA FISHER
  • NPI Number: 1124660485
  • Taxonomy: 251G00000X - Hospice Care, Community Based

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CLIA Record

Field Name Field Value
CLIA Number 45D2177984
LAB Type Hospice
Facility Name DIVINITY HOSPICE, LLC DBA DIVINITY HEALTHCARE
Street 5601 BRIDGE ST SUITE 504
City FORT WORTH
State TX
ZIP 76112
Phone 817 438-7463
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 1/23/2024
Certificate Expiration Date 1/22/2026
Facility Type Hospice
Lab Director BRENDA FISHER

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