01D2108056 CLIA NUMBER - SUNRISE DERMATOLOGY, LLC

Laboratory Demographics

  • CLIA Code: 01D2108056
  • Facility Name: SUNRISE DERMATOLOGY, LLC
  • Facility Address: 14714 ST STEPHENS AVENUE
    CHATOM, AL
    ZIP 36518
  • Facility Phone: 251 544-6407
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: SCOTT R. FREEMAN
  • NPI Number: 1649562521
  • Taxonomy: 207N00000X - Dermatology

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CLIA Record

Field Name Field Value
CLIA Number 01D2108056
LAB Type Physician Office
Facility Name SUNRISE DERMATOLOGY, LLC
Street 14714 ST STEPHENS AVENUE
City CHATOM
State AL
ZIP 36518
Phone 251 544-6407
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 1/27/2024
Certificate Expiration Date 1/26/2026
Facility Type Physician Office
Lab Director SCOTT R. FREEMAN

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