01D2048496 CLIA NUMBER - PURE DERMATOLOGY

Laboratory Demographics

  • CLIA Code: 01D2048496
  • Facility Name: PURE DERMATOLOGY
  • Facility Address: 5346 STADIUM TRACE PARKWAY SUITE 100
    HOOVER, AL
    ZIP 35244
  • Facility Phone: 205 682-8022
  • Facility Type: Physician Office
  • Facility Type: Microscopy
  • Lab Director: ELIZABETH S. MARTIN MD
  • NPI Number: 1104176700
  • Taxonomy: 207N00000X - Dermatology

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CLIA Record

Field Name Field Value
CLIA Number 01D2048496
LAB Type Physician Office
Facility Name PURE DERMATOLOGY
Street 5346 STADIUM TRACE PARKWAY SUITE 100
City HOOVER
State AL
ZIP 35244
Phone 205 682-8022
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 10/17/2024
Certificate Expiration Date 10/16/2026
Facility Type Physician Office
Lab Director ELIZABETH S. MARTIN MD

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