45D2004058 CLIA NUMBER - CENTER FOR DERMATOLOGY & COSMETIC LASER SURGERY - MCKINNEY

Laboratory Demographics

  • CLIA Code: 45D2004058
  • Facility Name: CENTER FOR DERMATOLOGY & COSMETIC LASER SURGERY - MCKINNEY
  • Facility Address: 4701 MEDICAL CENTER DRIVE SUITE 1B
    MCKINNEY, TX
    ZIP 75069
  • Facility Phone: 972 985-9003
  • Facility Type: Physician Office
  • Facility Type: Microscopy
  • Lab Director: SAM AWAN
  • NPI Number: 1063687739
  • Taxonomy: 106H00000X - Marriage & Family Therapist

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CLIA Record

Field Name Field Value
CLIA Number 45D2004058
LAB Type Physician Office
Facility Name CENTER FOR DERMATOLOGY & COSMETIC LASER SURGERY - MCKINNEY
Street 4701 MEDICAL CENTER DRIVE SUITE 1B
City MCKINNEY
State TX
ZIP 75069
Phone 972 985-9003
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 2/5/2024
Certificate Expiration Date 2/4/2026
Facility Type Physician Office
Lab Director SAM AWAN

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