45D2193785 CLIA NUMBER - TRIDENT HEART & VASCULAR, PLLC

Laboratory Demographics

  • CLIA Code: 45D2193785
  • Facility Name: TRIDENT HEART & VASCULAR, PLLC
  • Facility Address: 5801 OAKBEND TRL SUITE 270
    FORT WORTH, TX
    ZIP 76132
  • Facility Phone: 817 266-0224
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: SATISH CHANDRAPRAKASAM
  • NPI Number: 1497367015
  • Taxonomy: 207RC0000X - Internal Medicine

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CLIA Record

Field Name Field Value
CLIA Number 45D2193785
LAB Type Physician Office
Facility Name TRIDENT HEART & VASCULAR, PLLC
Street 5801 OAKBEND TRL SUITE 270
City FORT WORTH
State TX
ZIP 76132
Phone 817 266-0224
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 9/24/2024
Certificate Expiration Date 9/23/2026
Facility Type Physician Office
Lab Director SATISH CHANDRAPRAKASAM

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