45D2182039 CLIA NUMBER - PATRICK KEEHAN DO, PA DBA KEEHAN DERMATOLGOY

Laboratory Demographics

  • CLIA Code: 45D2182039
  • Facility Name: PATRICK KEEHAN DO, PA DBA KEEHAN DERMATOLGOY
  • Facility Address: 4625 SAINT AMAND CIRCLE
    FORT WORTH, TX
    ZIP 76126
  • Facility Phone: 817 769-3603
  • Facility Type: Physician Office
  • Facility Type: Microscopy
  • Lab Director: PATRICK J. KEEHAN
  • NPI Number: 1811533805
  • Taxonomy: 207N00000X - Dermatology

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CLIA Record

Field Name Field Value
CLIA Number 45D2182039
LAB Type Physician Office
Facility Name PATRICK KEEHAN DO, PA DBA KEEHAN DERMATOLGOY
Street 4625 SAINT AMAND CIRCLE
City FORT WORTH
State TX
ZIP 76126
Phone 817 769-3603
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 10/5/2024
Certificate Expiration Date 10/4/2026
Facility Type Physician Office
Lab Director PATRICK J. KEEHAN

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