04D2129901 CLIA NUMBER - TRUE DERMATOLOGY, PLLC

Laboratory Demographics

  • CLIA Code: 04D2129901
  • Facility Name: TRUE DERMATOLOGY, PLLC
  • Facility Address: 1438 EAST AUGUSTINE LANE STE 2
    FAYETTEVILLE, AR
    ZIP 72703
  • Facility Phone: 479 273-3376
  • Facility Type: Physician Office
  • Facility Type: Microscopy
  • Lab Director: DR. MILDRED CLIFTON
  • NPI Number: 1801210844
  • Taxonomy: 122300000X - Dentist

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CLIA Record

Field Name Field Value
CLIA Number 04D2129901
LAB Type Physician Office
Facility Name TRUE DERMATOLOGY, PLLC
Street 1438 EAST AUGUSTINE LANE STE 2
City FAYETTEVILLE
State AR
ZIP 72703
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 4/27/2025
Certificate Expiration Date 4/26/2027
Facility Type Physician Office
Lab Director DR. MILDRED CLIFTON

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