45D2066539 CLIA NUMBER - CINCO RANCH DERMATOLOGY, PA

Laboratory Demographics

  • CLIA Code: 45D2066539
  • Facility Name: CINCO RANCH DERMATOLOGY, PA
  • Facility Address: 23050 WESTHEIMER PKWY
    KATY, TX
    ZIP 77494
  • Facility Phone: 281 891-3690
  • Facility Type: Physician Office
  • Facility Type: Microscopy
  • Lab Director: KELLY B. CONNER
  • NPI Number: 1205220829
  • Taxonomy: 291U00000X - Clinical Medical Laboratory

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CLIA Record

Field Name Field Value
CLIA Number 45D2066539
LAB Type Physician Office
Facility Name CINCO RANCH DERMATOLOGY, PA
Street 23050 WESTHEIMER PKWY
City KATY
State TX
ZIP 77494
Phone 281 891-3690
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 9/27/2025
Certificate Expiration Date 9/26/2027
Facility Type Physician Office
Lab Director KELLY B. CONNER

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