45D2217263 CLIA NUMBER - VINE URGENT CARE, PLLC

Laboratory Demographics

  • CLIA Code: 45D2217263
  • Facility Name: VINE URGENT CARE, PLLC
  • Facility Address: 1661 EASTCHASE PKWY
    FORT WORTH, TX
    ZIP 76120
  • Facility Phone: 817 449-2555
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: EHAB I. HANNA
  • NPI Number: 1336746080
  • Taxonomy: 261QU0200X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 45D2217263
LAB Type Physician Office
Facility Name VINE URGENT CARE, PLLC
Street 1661 EASTCHASE PKWY
City FORT WORTH
State TX
ZIP 76120
Phone 817 449-2555
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 3/19/2025
Certificate Expiration Date 3/18/2027
Facility Type Physician Office
Lab Director EHAB I. HANNA

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