45D2321138 CLIA NUMBER - DENTISTS AT CHISHOLM TRAIL

Laboratory Demographics

  • CLIA Code: 45D2321138
  • Facility Name: DENTISTS AT CHISHOLM TRAIL
  • Facility Address: 9604 TEN GALLON DR
    FORT WORTH, TX
    ZIP 76123
  • Facility Phone: 817 803-4362
  • Facility Type: Practitioner Other
  • Facility Type: Waiver
  • Lab Director: JOYANNA JOFFMAN
  • NPI Number: 1770118911
  • Taxonomy: 1223G0001X - Dentist

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CLIA Record

Field Name Field Value
CLIA Number 45D2321138
LAB Type Practitioner Other
Facility Name DENTISTS AT CHISHOLM TRAIL
Street 9604 TEN GALLON DR
City FORT WORTH
State TX
ZIP 76123
Phone 817 803-4362
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 3/31/2025
Certificate Expiration Date 3/30/2027
Facility Type Practitioner Other
Lab Director JOYANNA JOFFMAN

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