45D2327593 CLIA NUMBER - PRODERM PLLC

Laboratory Demographics

  • CLIA Code: 45D2327593
  • Facility Name: PRODERM PLLC
  • Facility Address: 4516 SETON CENTER PKWY # 150
    AUSTIN, TX
    ZIP 78759
  • Facility Phone: 512 535-6000
  • Facility Type: Physician Office
  • Facility Type: Certificate of Compliance
  • Lab Director: SYDNEY L. PROFFER
  • NPI Number: 1184410987
  • Taxonomy: 207ND0101X - Dermatology

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CLIA Record

Field Name Field Value
CLIA Number 45D2327593
LAB Type Physician Office
Facility Name PRODERM PLLC
Street 4516 SETON CENTER PKWY # 150
City AUSTIN
State TX
ZIP 78759
Phone 512 535-6000
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 7/24/2025
Certificate Expiration Date 7/23/2027
Facility Type Physician Office
Lab Director SYDNEY L. PROFFER

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