45D2007100 CLIA NUMBER - EPIPHANY DERMATOLOGY, PA

Laboratory Demographics

  • CLIA Code: 45D2007100
  • Facility Name: EPIPHANY DERMATOLOGY, PA
  • Facility Address: 912 FOSTER LANE #200
    WEATHERFORD, TX
    ZIP 76086
  • Facility Phone: 817 489-6789
  • Facility Type: Physician Office
  • Facility Type: Certificate of Compliance
  • Lab Director: KAITLIN C. BLANKENSHIP

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CLIA Record

Field Name Field Value
CLIA Number 45D2007100
LAB Type Physician Office
Facility Name EPIPHANY DERMATOLOGY, PA
Street 912 FOSTER LANE #200
City WEATHERFORD
State TX
ZIP 76086
Phone 817 489-6789
Certificate Type Certificate of Compliance
Certificate Type Description This certificate is issued to a laboratory after an inspection that finds the laboratory to be in compliance with all applicable CLIA requirements.
Certificate Effective Date 10/17/2023
Certificate Expiration Date 10/16/2025
Facility Type Physician Office
Lab Director KAITLIN C. BLANKENSHIP

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This page was last updated on: 6/4/2025