45D2039010 CLIA NUMBER - BALCONES DERMATOLOGY ASSOCIATES, PA

Laboratory Demographics

  • CLIA Code: 45D2039010
  • Facility Name: BALCONES DERMATOLOGY ASSOCIATES, PA
  • Facility Address: 7800 N MOPAC EXPWY, SUITE 315
    AUSTIN, TX
    ZIP 78759
  • Facility Phone: 512 459-4869
  • Facility Type: Physician Office
  • Facility Type: Microscopy
  • Lab Director: DAVID BUSHORE
  • NPI Number: 1255705778
  • Taxonomy: 207Q00000X - Family Medicine

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CLIA Record

Field Name Field Value
CLIA Number 45D2039010
LAB Type Physician Office
Facility Name BALCONES DERMATOLOGY ASSOCIATES, PA
Street 7800 N MOPAC EXPWY, SUITE 315
City AUSTIN
State TX
ZIP 78759
Phone 512 459-4869
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 3/29/2024
Certificate Expiration Date 3/28/2026
Facility Type Physician Office
Lab Director DAVID BUSHORE

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