45D0481625 CLIA NUMBER - SAMUEL P MARYNICK MD

Laboratory Demographics

  • CLIA Code: 45D0481625
  • Facility Name: SAMUEL P MARYNICK MD
  • Facility Address: 3600 GASTON AVE SUITE 506
    DALLAS, TX
    ZIP 75246
  • Facility Phone: 214 828-2444
  • Facility Type: Physician Office
  • Facility Type: Microscopy
  • Lab Director: SAMUEL P. MARYNICK MD
  • NPI Number: 1982130779
  • Taxonomy: 1223S0112X - Dentist

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CLIA Record

Field Name Field Value
CLIA Number 45D0481625
LAB Type Physician Office
Facility Name SAMUEL P MARYNICK MD
Street 3600 GASTON AVE SUITE 506
City DALLAS
State TX
ZIP 75246
Phone 214 828-2444
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 9/1/2024
Certificate Expiration Date 8/31/2026
Facility Type Physician Office
Lab Director SAMUEL P. MARYNICK MD

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