45D2173789 CLIA NUMBER - FAIRVIEW DERMATOLOGY

Laboratory Demographics

  • CLIA Code: 45D2173789
  • Facility Name: FAIRVIEW DERMATOLOGY
  • Facility Address: 331 TOWN PLACE
    FAIRVIEW, TX
    ZIP 75069
  • Facility Phone: (972) 747-0000
  • Facility Type: Physician Office
  • Facility Type: Microscopy
  • Lab Director: ANDREW D. HUDSON
  • NPI Number: 1073014114
  • Taxonomy: 207N00000X - Dermatology

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CLIA Record

Field Name Field Value
CLIA Number 45D2173789
LAB Type Physician Office
Facility Name FAIRVIEW DERMATOLOGY
Street 331 TOWN PLACE
City FAIRVIEW
State TX
ZIP 75069
Phone 9727470000
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 10/18/2025
Certificate Expiration Date 10/17/2027
Facility Type Physician Office
Lab Director ANDREW D. HUDSON

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This page was last updated on: 5/18/2026