Clinical Laboratory Information
Similar CLIA Codes
|
|
CLIA Number
|
45D0703264
|
|
Clinical laboratory number
|
|
Lab Name
|
MARK D SMITH, MD, PA
|
|
Laboratory Name
|
|
Lab Type
|
Physician Office
|
|
Laboratory Type
|
|
Certificate Type
|
PPMP
|
|
Clinical laboratory certificate type
|
Contacts |
|
Phone
|
817-370-2657
|
|
Laboratory telephone number
|
|
Fax
|
817-370-0088
|
|
Fax number of the provider.
|
Facility Location |
|
Street Address
|
7100 OAKMONT BOULEVARD SUITE 202
|
|
Primary location adress line
|
|
City
|
FORT WORTH
|
|
Primary location city name
|
|
State
|
TX
|
|
Primary location state name
|
|
Zip
|
76132-3900
|
|
Primary location postal code
|