45D2204549 CLIA NUMBER - CLEAR FORK ASSISTED LIVING & MEMORY CARE

Laboratory Demographics

  • CLIA Code: 45D2204549
  • Facility Name: CLEAR FORK ASSISTED LIVING & MEMORY CARE
  • Facility Address: 178 CROWN POINTE BLVD
    WILLOW PARK, TX
    ZIP 76087
  • Facility Phone: 817 386-8326
  • Facility Type: Ancillary Testing Site in Health Care Center
  • Facility Type: Waiver
  • Lab Director: JANET FORAN
  • NPI Number: 1275021560
  • Taxonomy: 103TC0700X - Psychologist

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CLIA Record

Field Name Field Value
CLIA Number 45D2204549
LAB Type Ancillary Testing Site in Health Care Center
Facility Name CLEAR FORK ASSISTED LIVING & MEMORY CARE
Street 178 CROWN POINTE BLVD
City WILLOW PARK
State TX
ZIP 76087
Phone 817 386-8326
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 12/9/2024
Certificate Expiration Date 12/8/2026
Facility Type Ancillary Testing Site in Health Care Center
Lab Director JANET FORAN

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