45D1024613 CLIA NUMBER - BEAUMONT DERMATOLOGY AND FAMILY PRACTICE LLP

Laboratory Demographics

  • CLIA Code: 45D1024613
  • Facility Name: BEAUMONT DERMATOLOGY AND FAMILY PRACTICE LLP
  • Facility Address: 3030 NORTH STREET SUITE 430
    BEAUMONT, TX
    ZIP 77702
  • Facility Phone: 409 899-2500
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: SIDNEY A. MARCHAND
  • NPI Number: 1699222919
  • Taxonomy: 207K00000X - Allergy & Immunology

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CLIA Record

Field Name Field Value
CLIA Number 45D1024613
LAB Type Physician Office
Facility Name BEAUMONT DERMATOLOGY AND FAMILY PRACTICE LLP
Street 3030 NORTH STREET SUITE 430
City BEAUMONT
State TX
ZIP 77702
Phone 409 899-2500
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 12/29/2024
Certificate Expiration Date 12/28/2026
Facility Type Physician Office
Lab Director SIDNEY A. MARCHAND

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This page was last updated on: 3/20/2025