45D2258312 CLIA NUMBER - CLEAR CREEK DERMATOLOGY

Laboratory Demographics

  • CLIA Code: 45D2258312
  • Facility Name: CLEAR CREEK DERMATOLOGY
  • Facility Address: 904 FORD ST
    LLANO, TX
    ZIP 78643
  • Facility Phone: 830 953-1700
  • Facility Type: Physician Office
  • Facility Type: Certificate of Compliance
  • Lab Director: EMILY L. PROSISE
  • NPI Number: 1013667161
  • Taxonomy: 207N00000X - Dermatology

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CLIA Record

Field Name Field Value
CLIA Number 45D2258312
LAB Type Physician Office
Facility Name CLEAR CREEK DERMATOLOGY
Street 904 FORD ST
City LLANO
State TX
ZIP 78643
Phone 830 953-1700
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 1/3/2025
Certificate Expiration Date 1/2/2027
Facility Type Physician Office
Lab Director EMILY L. PROSISE

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