45D2159884 CLIA NUMBER - DERMASURGERY SPECIALIST, PLLC

Laboratory Demographics

  • CLIA Code: 45D2159884
  • Facility Name: DERMASURGERY SPECIALIST, PLLC
  • Facility Address: 2020 WEST STATE HIGHWAY 114 SUITE 340
    GRAPEVINE, TX
    ZIP 76051
  • Facility Phone: 817 410-7700
  • Facility Type: Physician Office
  • Facility Type: Certificate of Compliance
  • Lab Director: SAIRA B. MOMIN
  • NPI Number: 1063988541
  • Taxonomy: 207ND0101X - Dermatology

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CLIA Record

Field Name Field Value
CLIA Number 45D2159884
LAB Type Physician Office
Facility Name DERMASURGERY SPECIALIST, PLLC
Street 2020 WEST STATE HIGHWAY 114 SUITE 340
City GRAPEVINE
State TX
ZIP 76051
Phone 817 410-7700
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 4/30/2025
Certificate Expiration Date 4/29/2027
Facility Type Physician Office
Lab Director SAIRA B. MOMIN

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