45D2314128 CLIA NUMBER - FOUNDATION FAMILY PRACTICE

Laboratory Demographics

  • CLIA Code: 45D2314128
  • Facility Name: FOUNDATION FAMILY PRACTICE
  • Facility Address: 3120 CAPITAL WAY, UNIT 602
    FORT WORTH, TX
    ZIP 76177
  • Facility Phone: 817 704-3345
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: OLADOTUN O. AKINMURELE
  • NPI Number: 1699516914
  • Taxonomy: 207R00000X - Internal Medicine

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CLIA Record

Field Name Field Value
CLIA Number 45D2314128
LAB Type Physician Office
Facility Name FOUNDATION FAMILY PRACTICE
Street 3120 CAPITAL WAY, UNIT 602
City FORT WORTH
State TX
ZIP 76177
Phone 817 704-3345
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 11/14/2024
Certificate Expiration Date 11/13/2026
Facility Type Physician Office
Lab Director OLADOTUN O. AKINMURELE

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