45D2238646 CLIA NUMBER - PORTLAND DERMATOLOGY

Laboratory Demographics

  • CLIA Code: 45D2238646
  • Facility Name: PORTLAND DERMATOLOGY
  • Facility Address: 277 BUDDY GANEM, SUITE B
    PORTLAND, TX
    ZIP 78374
  • Facility Phone: 361 229-7400
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: ALPESH D. DESAI
  • NPI Number: 1720677354
  • Taxonomy: 207P00000X - Emergency Medicine

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CLIA Record

Field Name Field Value
CLIA Number 45D2238646
LAB Type Physician Office
Facility Name PORTLAND DERMATOLOGY
Street 277 BUDDY GANEM, SUITE B
City PORTLAND
State TX
ZIP 78374
Phone 361 229-7400
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 10/5/2025
Certificate Expiration Date 10/4/2027
Facility Type Physician Office
Lab Director ALPESH D. DESAI

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