45D2150868 CLIA NUMBER - HUMBLE DERMATOLOGY

Laboratory Demographics

  • CLIA Code: 45D2150868
  • Facility Name: HUMBLE DERMATOLOGY
  • Facility Address: 18980 NORTH MEMORIAL DRIVE, SUITE 200
    HUMBLE, TX
    ZIP 77338
  • Facility Phone: 832 955-4426
  • Facility Type: Physician Office
  • Facility Type: Microscopy
  • Lab Director: ADAEZE EGESI
  • NPI Number: 1679064968
  • Taxonomy: 207N00000X - Dermatology

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CLIA Record

Field Name Field Value
CLIA Number 45D2150868
LAB Type Physician Office
Facility Name HUMBLE DERMATOLOGY
Street 18980 NORTH MEMORIAL DRIVE, SUITE 200
City HUMBLE
State TX
ZIP 77338
Phone 832 955-4426
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 7/6/2024
Certificate Expiration Date 7/5/2026
Facility Type Physician Office
Lab Director ADAEZE EGESI

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