04D2104614 CLIA NUMBER - TRUE DERMATOLOGY PLLC

Laboratory Demographics

  • CLIA Code: 04D2104614
  • Facility Name: TRUE DERMATOLOGY PLLC
  • Facility Address: 14 RIORDAN RD
    BELLA VISTA, AR
    ZIP 72714
  • Facility Phone: 479 273-3376
  • Facility Type: Physician Office
  • Facility Type: Microscopy
  • Lab Director: DR. MILDRED M. CLIFTON
  • NPI Number: 1386022283
  • Taxonomy: 207N00000X - Dermatology

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CLIA Record

Field Name Field Value
CLIA Number 04D2104614
LAB Type Physician Office
Facility Name TRUE DERMATOLOGY PLLC
Street 14 RIORDAN RD
City BELLA VISTA
State AR
ZIP 72714
Phone 479 273-3376
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 11/9/2023
Certificate Expiration Date 11/8/2025
Facility Type Physician Office
Lab Director DR. MILDRED M. CLIFTON

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