45D1007078 CLIA NUMBER - KIM M ROSS MD

Laboratory Demographics

  • CLIA Code: 45D1007078
  • Facility Name: KIM M ROSS MD
  • Facility Address: 1303 MCCULLOUGH SUITE 525
    SAN ANTONIO, TX
    ZIP 78212
  • Facility Phone: 210 225-2769
  • Facility Type: Physician Office
  • Facility Type: Microscopy
  • Lab Director: KIM M. ROSS
  • NPI Number: 1134553019
  • Taxonomy: 207N00000X - Dermatology

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CLIA Record

Field Name Field Value
CLIA Number 45D1007078
LAB Type Physician Office
Facility Name KIM M ROSS MD
Street 1303 MCCULLOUGH SUITE 525
City SAN ANTONIO
State TX
ZIP 78212
Phone 210 225-2769
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 12/9/2024
Certificate Expiration Date 12/8/2026
Facility Type Physician Office
Lab Director KIM M. ROSS

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