45D2316066 CLIA NUMBER - SKYLINE MEDICAL PLLC

Laboratory Demographics

  • CLIA Code: 45D2316066
  • Facility Name: SKYLINE MEDICAL PLLC
  • Facility Address: 200 BUTTERCUP CREEK BLVD STE 115
    CEDAR PARK, TX
    ZIP 78613
  • Facility Phone: 512 777-1211
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: DAVID J. KIM
  • NPI Number: 1760200216
  • Taxonomy: 208VP0014X - Pain Medicine

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CLIA Record

Field Name Field Value
CLIA Number 45D2316066
LAB Type Physician Office
Facility Name SKYLINE MEDICAL PLLC
Street 200 BUTTERCUP CREEK BLVD STE 115
City CEDAR PARK
State TX
ZIP 78613
Phone 512 777-1211
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 12/27/2024
Certificate Expiration Date 12/26/2026
Facility Type Physician Office
Lab Director DAVID J. KIM

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