07D0907154 CLIA NUMBER - YALE MEDICINE DERMATOLOGY

Laboratory Demographics

  • CLIA Code: 07D0907154
  • Facility Name: YALE MEDICINE DERMATOLOGY
  • Facility Address: 2 CHURCH ST SOUTH, STE 305
    NEW HAVEN, CT
    ZIP 06519
  • Facility Phone: 203 789-4445
  • Facility Type: Physician Office
  • Facility Type: Microscopy
  • Lab Director: RICHARD ANTAYA
  • NPI Number: 1205822236
  • Taxonomy: 207L00000X - Anesthesiology

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CLIA Record

Field Name Field Value
CLIA Number 07D0907154
LAB Type Physician Office
Facility Name YALE MEDICINE DERMATOLOGY
Street 2 CHURCH ST SOUTH, STE 305
City NEW HAVEN
State CT
ZIP 06519
Phone 203 789-4445
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 2/3/2024
Certificate Expiration Date 2/2/2026
Facility Type Physician Office
Lab Director RICHARD ANTAYA

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