01D2018153 CLIA NUMBER - AQUA DERMATOLOGY OF ALABAMA PC SURGICAL DERMATOLOGY GROUP

Laboratory Demographics

  • CLIA Code: 01D2018153
  • Facility Name: AQUA DERMATOLOGY OF ALABAMA PC SURGICAL DERMATOLOGY GROUP
  • Facility Address: 1401 EDWARDS LAKE ROAD
    BIRMINGHAM, AL
    ZIP 35235
  • Facility Phone: 205 977-9876
  • Facility Type: Physician Office
  • Facility Type: Certificate of Compliance
  • Lab Director: DR. JONATHAN A. CAPPEL
  • NPI Number: 1497791628
  • Taxonomy: 207ND0101X - Dermatology

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CLIA Record

Field Name Field Value
CLIA Number 01D2018153
LAB Type Physician Office
Facility Name AQUA DERMATOLOGY OF ALABAMA PC SURGICAL DERMATOLOGY GROUP
Street 1401 EDWARDS LAKE ROAD
City BIRMINGHAM
State AL
ZIP 35235
Phone 205 977-9876
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 11/3/2023
Certificate Expiration Date 11/2/2025
Facility Type Physician Office
Lab Director DR. JONATHAN A. CAPPEL

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