45D2272349 CLIA NUMBER - FW SPECIALTY SURGICARE

Laboratory Demographics

  • CLIA Code: 45D2272349
  • Facility Name: FW SPECIALTY SURGICARE
  • Facility Address: 2001 COOPER ST
    FORT WORTH, TX
    ZIP 76104
  • Facility Phone: 817 348-9090
  • Facility Type: Ambulatory Surgery Center
  • Facility Type: Waiver
  • Lab Director: RICHARD CHU
  • NPI Number: 1174258107
  • Taxonomy: 261QA1903X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 45D2272349
LAB Type Ambulatory Surgery Center
Facility Name FW SPECIALTY SURGICARE
Street 2001 COOPER ST
City FORT WORTH
State TX
ZIP 76104
Phone 817 348-9090
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 11/18/2024
Certificate Expiration Date 11/17/2026
Facility Type Ambulatory Surgery Center
Lab Director RICHARD CHU

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