45D1029198 CLIA NUMBER - SPICEWOOD DERMATOLOGY PA

Laboratory Demographics

  • CLIA Code: 45D1029198
  • Facility Name: SPICEWOOD DERMATOLOGY PA
  • Facility Address: 13642 N HWY 183 BLDG 2 STE 100
    AUSTIN, TX
    ZIP 78750
  • Facility Phone: 512 831-7300
  • Facility Type: Physician Office
  • Facility Type: Microscopy
  • Lab Director: DANA C. JENG
  • NPI Number: 1083176309
  • Taxonomy: 261QA1903X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 45D1029198
LAB Type Physician Office
Facility Name SPICEWOOD DERMATOLOGY PA
Street 13642 N HWY 183 BLDG 2 STE 100
City AUSTIN
State TX
ZIP 78750
Phone 512 831-7300
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 8/12/2024
Certificate Expiration Date 8/11/2026
Facility Type Physician Office
Lab Director DANA C. JENG

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