45D2217938 CLIA NUMBER - ESSENTIAL DERMATOLOGY GROUP, PLLC

Laboratory Demographics

  • CLIA Code: 45D2217938
  • Facility Name: ESSENTIAL DERMATOLOGY GROUP, PLLC
  • Facility Address: 1600 CENTRAL DR SUITE 158
    BEDFORD, TX
    ZIP 76022
  • Facility Phone: 817 736-2912
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: CALVIN WILLIAMS
  • NPI Number: 1396338190
  • Taxonomy: 207N00000X - Dermatology

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CLIA Record

Field Name Field Value
CLIA Number 45D2217938
LAB Type Physician Office
Facility Name ESSENTIAL DERMATOLOGY GROUP, PLLC
Street 1600 CENTRAL DR SUITE 158
City BEDFORD
State TX
ZIP 76022
Phone 817 736-2912
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 3/24/2025
Certificate Expiration Date 3/23/2027
Facility Type Physician Office
Lab Director CALVIN WILLIAMS

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