45D2281553 CLIA NUMBER - FORT WORTH PLASTIC SURGERY CENTER

Laboratory Demographics

  • CLIA Code: 45D2281553
  • Facility Name: FORT WORTH PLASTIC SURGERY CENTER
  • Facility Address: 800 12TH AVE SUITE 300
    FORT WORTH, TX
    ZIP 76104
  • Facility Phone: 281 731-3783
  • Facility Type: Ambulatory Surgery Center
  • Facility Type: Waiver
  • Lab Director: MARK ANTHONY DANIELS
  • NPI Number: 1710929260
  • Taxonomy: 207XS0106X - Orthopaedic Surgery

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CLIA Record

Field Name Field Value
CLIA Number 45D2281553
LAB Type Ambulatory Surgery Center
Facility Name FORT WORTH PLASTIC SURGERY CENTER
Street 800 12TH AVE SUITE 300
City FORT WORTH
State TX
ZIP 76104
Phone 281 731-3783
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 5/9/2025
Certificate Expiration Date 5/8/2027
Facility Type Ambulatory Surgery Center
Lab Director MARK ANTHONY DANIELS

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