45D2262858 CLIA NUMBER - WILLOW PARK ENDOSCOPY CENTER, LLC

Laboratory Demographics

  • CLIA Code: 45D2262858
  • Facility Name: WILLOW PARK ENDOSCOPY CENTER, LLC
  • Facility Address: 130 JIMMA DR SUITE B
    WILLOW PARK, TX
    ZIP 76087
  • Facility Phone: 817 893-2381
  • Facility Type: Ambulatory Surgery Center
  • Facility Type: Waiver
  • Lab Director: SANJEEB SHRESTHA
  • NPI Number: 1487399168
  • Taxonomy: 261QA1903X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 45D2262858
LAB Type Ambulatory Surgery Center
Facility Name WILLOW PARK ENDOSCOPY CENTER, LLC
Street 130 JIMMA DR SUITE B
City WILLOW PARK
State TX
ZIP 76087
Phone 817 893-2381
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 6/20/2024
Certificate Expiration Date 6/19/2026
Facility Type Ambulatory Surgery Center
Lab Director SANJEEB SHRESTHA

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