45D1006150 CLIA NUMBER - ROBERT J DOUGHERTY M D P A

Laboratory Demographics

  • CLIA Code: 45D1006150
  • Facility Name: ROBERT J DOUGHERTY M D P A
  • Facility Address: 623 HIGHWAY 71 WEST,SUITE 204
    BASTROP, TX
    ZIP 78602
  • Facility Phone: 512 581-5016
  • Facility Type: Physician Office
  • Facility Type: Microscopy
  • Lab Director: ROBERT J. DOUGHERTY
  • NPI Number: 1376518480
  • Taxonomy: 152W00000X - Optometrist

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CLIA Record

Field Name Field Value
CLIA Number 45D1006150
LAB Type Physician Office
Facility Name ROBERT J DOUGHERTY M D P A
Street 623 HIGHWAY 71 WEST,SUITE 204
City BASTROP
State TX
ZIP 78602
Phone 512 581-5016
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 11/8/2024
Certificate Expiration Date 11/7/2026
Facility Type Physician Office
Lab Director ROBERT J. DOUGHERTY

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