04D2154565 CLIA NUMBER - ADVANCED DERMATOLOGY & SKIN CANCER CENTER

Laboratory Demographics

  • CLIA Code: 04D2154565
  • Facility Name: ADVANCED DERMATOLOGY & SKIN CANCER CENTER
  • Facility Address: 1324 NORTH HWY 62/65 SIERRA CENTER, SUITE C2
    HARRISON, AR
    ZIP 72601
  • Facility Phone: 479 718-7546
  • Facility Type: Physician Office
  • Facility Type: Microscopy
  • Lab Director: DR. HENRY B. LANCE
  • NPI Number: 1659310381
  • Taxonomy: 207X00000X - Orthopaedic Surgery

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CLIA Record

Field Name Field Value
CLIA Number 04D2154565
LAB Type Physician Office
Facility Name ADVANCED DERMATOLOGY & SKIN CANCER CENTER
Street 1324 NORTH HWY 62/65 SIERRA CENTER, SUITE C2
City HARRISON
State AR
ZIP 72601
Phone 479 718-7546
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 7/15/2025
Certificate Expiration Date 7/14/2027
Facility Type Physician Office
Lab Director DR. HENRY B. LANCE

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