45D2228951 CLIA NUMBER - IKIDS PEDIATRIC CARE, PLLC

Laboratory Demographics

  • CLIA Code: 45D2228951
  • Facility Name: IKIDS PEDIATRIC CARE, PLLC
  • Facility Address: 1900 W EVERMAN PARKWAY SUITE 100
    FORT WORTH, TX
    ZIP 76134
  • Facility Phone: 682 703-2051
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: YESENIA GUTIERREZ
  • NPI Number: 1033783451
  • Taxonomy: 208000000X - Pediatrics

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CLIA Record

Field Name Field Value
CLIA Number 45D2228951
LAB Type Physician Office
Facility Name IKIDS PEDIATRIC CARE, PLLC
Street 1900 W EVERMAN PARKWAY SUITE 100
City FORT WORTH
State TX
ZIP 76134
Phone 682 703-2051
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 7/3/2025
Certificate Expiration Date 7/2/2027
Facility Type Physician Office
Lab Director YESENIA GUTIERREZ

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