45D2255483 CLIA NUMBER - UNT HSC PEDIATRIC MOBILE CLINIC

Laboratory Demographics

  • CLIA Code: 45D2255483
  • Facility Name: UNT HSC PEDIATRIC MOBILE CLINIC
  • Facility Address: 855 MONTGOMERY ST PEDIATRICS & WOMENS HEALTH
    FORT WORTH, TX
    ZIP 76107
  • Facility Phone: 817 929-5437
  • Facility Type: Mobile Laboratory
  • Facility Type: Waiver
  • Lab Director: CHRISTINA CASTLEBERRY ROBINSON
  • NPI Number: 1790095362
  • Taxonomy: 291U00000X - Clinical Medical Laboratory

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CLIA Record

Field Name Field Value
CLIA Number 45D2255483
LAB Type Mobile Laboratory
Facility Name UNT HSC PEDIATRIC MOBILE CLINIC
Street 855 MONTGOMERY ST PEDIATRICS & WOMENS HEALTH
City FORT WORTH
State TX
ZIP 76107
Phone 817 929-5437
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 3/15/2024
Certificate Expiration Date 3/14/2026
Facility Type Mobile Laboratory
Lab Director CHRISTINA CASTLEBERRY ROBINSON

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