45D2118176 CLIA NUMBER - FORT WORTH DERMATOLOGY CENTER, PLLC

Laboratory Demographics

  • CLIA Code: 45D2118176
  • Facility Name: FORT WORTH DERMATOLOGY CENTER, PLLC
  • Facility Address: 6900 HARRIS PARKWAY, SUITE 200
    FORT WORTH, TX
    ZIP 76132
  • Facility Phone: 817 292-3376
  • Facility Type: Physician Office
  • Facility Type: Microscopy
  • Lab Director: ROSELYNN H. NGUYEN
  • NPI Number: 1598968505
  • Taxonomy: 225100000X - Physical Therapist

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CLIA Record

Field Name Field Value
CLIA Number 45D2118176
LAB Type Physician Office
Facility Name FORT WORTH DERMATOLOGY CENTER, PLLC
Street 6900 HARRIS PARKWAY, SUITE 200
City FORT WORTH
State TX
ZIP 76132
Phone 817 292-3376
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 9/1/2024
Certificate Expiration Date 8/31/2026
Facility Type Physician Office
Lab Director ROSELYNN H. NGUYEN

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