01D1082757 CLIA NUMBER - MOBILE DERMATOLOGY PC

Laboratory Demographics

  • CLIA Code: 01D1082757
  • Facility Name: MOBILE DERMATOLOGY PC
  • Facility Address: 6163 OMNI PARK DRIVE
    MOBILE, AL
    ZIP 36609
  • Facility Phone: 251 635-1315
  • Facility Type: Physician Office
  • Facility Type: Microscopy
  • Lab Director: JOHN SCOTT VANLOOCK MD
  • NPI Number: 1548432719
  • Taxonomy: 207N00000X - Dermatology

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CLIA Record

Field Name Field Value
CLIA Number 01D1082757
LAB Type Physician Office
Facility Name MOBILE DERMATOLOGY PC
Street 6163 OMNI PARK DRIVE
City MOBILE
State AL
ZIP 36609
Phone 251 635-1315
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 4/17/2024
Certificate Expiration Date 4/16/2026
Facility Type Physician Office
Lab Director JOHN SCOTT VANLOOCK MD

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