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45D0962094 CLIA NUMBER - LADERA PARK DERMATOLOGY, PA

Laboratory Demographics

CLIA Number: 45D0962094

Facility Name: LADERA PARK DERMATOLOGY, PA

Facility Address:
11671 JOLLYVILLE ROAD, SUITE 104
AUSTIN, TX
ZIP 78759
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Facility Phone Number: 512 345-3599

Facility Type: Physician Office

Certificate Type: Microscopy
NPI Number: 1225567704

Taxonomy: 207N00000X - Dermatology
A dermatologist is trained to diagnose and treat pediatric and adult patients with benign and malignant disorders of the skin, mouth, external genitalia, hair and nails, as well as a number of sexually transmitted diseases. The dermatologist has had additional training and experience in the diagnosis and treatment of skin cancers, melanomas, moles and other tumors of the skin, the management of contact dermatitis and other allergic and nonallergic skin disorders, and in the recognition of the skin manifestations of systemic (including internal malignancy) and infectious diseases. Dermatologists have special training in dermatopathology and in the surgical techniques used in dermatology. They also have expertise in the management of cosmetic disorders of the skin such as hair loss and scars and the skin changes associated with aging.

CLIA Record

Field Name Field Value
CLIA Number 45D0962094
LAB Type Physician Office
Facility Name LADERA PARK DERMATOLOGY, PA
Street 11671 JOLLYVILLE ROAD, SUITE 104
City AUSTIN
State TX
ZIP 78759
Phone 512 345-3599
CertificateType 3
CertificateEffectiveDate 6/23/2023
CertificateExpirationDate 6/22/2025
FacilityType PPMP

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This page was last updated on: 4/23/2024