45D2102276 CLIA NUMBER - WARTHAN DERMATOLOGY MOHS SKIN CANCER SURGERY CENTER

Laboratory Demographics

  • CLIA Code: 45D2102276
  • Facility Name: WARTHAN DERMATOLOGY MOHS SKIN CANCER SURGERY CENTER
  • Facility Address: 5751 EDWARDS RANCH RD SUITE 101
    FORT WORTH, TX
    ZIP 76109
  • Facility Phone: 817 923-8220
  • Facility Type: Physician Office
  • Facility Type: Certificate of Compliance
  • Lab Director: MOLLY M. WARTHAN
  • NPI Number: 1003350760
  • Taxonomy: 207N00000X - Dermatology

Map and Directions

Get Directions

CLIA Record

Field Name Field Value
CLIA Number 45D2102276
LAB Type Physician Office
Facility Name WARTHAN DERMATOLOGY MOHS SKIN CANCER SURGERY CENTER
Street 5751 EDWARDS RANCH RD SUITE 101
City FORT WORTH
State TX
ZIP 76109
Phone 817 923-8220
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 11/7/2023
Certificate Expiration Date 11/6/2025
Facility Type Physician Office
Lab Director MOLLY M. WARTHAN

Download Record

Download this CLIA record record in Text format: Export

Download this CLIA record record in Excel (CSV) format: Export

Download this CLIA record record in XML format: Export

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