45D0477708 CLIA NUMBER - ADAM S MINER, MD DBA PROMENADE FAMILY MEDICINE

Laboratory Demographics

  • CLIA Code: 45D0477708
  • Facility Name: ADAM S MINER, MD DBA PROMENADE FAMILY MEDICINE
  • Facility Address: 1120 W CAMPBELL ROAD, SUITE 111
    RICHARDSON, TX
    ZIP 75080
  • Facility Phone: 972 234-6868
  • Facility Type: Physician Office
  • Facility Type: Microscopy
  • Lab Director: ADAM S. MINER
  • NPI Number: 1467454603
  • Taxonomy: 207Q00000X - Family Medicine

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CLIA Record

Field Name Field Value
CLIA Number 45D0477708
LAB Type Physician Office
Facility Name ADAM S MINER, MD DBA PROMENADE FAMILY MEDICINE
Street 1120 W CAMPBELL ROAD, SUITE 111
City RICHARDSON
State TX
ZIP 75080
Phone 972 234-6868
Certificate Type Certificate for Provider-Performed Microscopy Procedures (PPMP)
Certificate Type Description This certificate is issued to a laboratory in which a physician, midlevel practitioner or dentist performs no tests other than the microscopy procedures. This certificate permits the laboratory to also perform waived tests.
Certificate Effective Date 3/7/2024
Certificate Expiration Date 3/6/2026
Facility Type Physician Office
Lab Director ADAM S. MINER

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