01D2046579 CLIA NUMBER - SOUTHERN SKIES DERMATOLOGY & SURGERY

Laboratory Demographics

  • CLIA Code: 01D2046579
  • Facility Name: SOUTHERN SKIES DERMATOLOGY & SURGERY
  • Facility Address: 48 MEDICAL PARK DRIVE EAST SUITE 458
    BIRMINGHAM, AL
    ZIP 35235
  • Facility Phone: 205 838-1811
  • Facility Type: Physician Office
  • Facility Type: Certificate of Compliance
  • Lab Director: MARIO K. MARUTHUR
  • NPI Number: 1649528134
  • Taxonomy: 207N00000X - Dermatology

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CLIA Record

Field Name Field Value
CLIA Number 01D2046579
LAB Type Physician Office
Facility Name SOUTHERN SKIES DERMATOLOGY & SURGERY
Street 48 MEDICAL PARK DRIVE EAST SUITE 458
City BIRMINGHAM
State AL
ZIP 35235
Phone 205 838-1811
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 8/20/2023
Certificate Expiration Date 9/30/2025
Facility Type Physician Office
Lab Director MARIO K. MARUTHUR

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