45D2262443 CLIA NUMBER - MAGNOLIA DERMATOLOGY

Laboratory Demographics

  • CLIA Code: 45D2262443
  • Facility Name: MAGNOLIA DERMATOLOGY
  • Facility Address: 10547 FRY ROAD
    CYPRESS, TX
    ZIP 77433
  • Facility Phone: 832 834-3349
  • Facility Type: Physician Office
  • Facility Type: Microscopy
  • Lab Director: SAMANTHA J. ROBARE
  • NPI Number: 1235890807
  • Taxonomy: 207N00000X - Dermatology

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CLIA Record

Field Name Field Value
CLIA Number 45D2262443
LAB Type Physician Office
Facility Name MAGNOLIA DERMATOLOGY
Street 10547 FRY ROAD
City CYPRESS
State TX
ZIP 77433
Phone 832 834-3349
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 6/14/2024
Certificate Expiration Date 6/13/2026
Facility Type Physician Office
Lab Director SAMANTHA J. ROBARE

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