07D2317708 CLIA NUMBER - ELITE DERMATOLOGY PHYSICIANS

Laboratory Demographics

  • CLIA Code: 07D2317708
  • Facility Name: ELITE DERMATOLOGY PHYSICIANS
  • Facility Address: 38 EAST AVE
    NEW CANAAN, CT
    ZIP 06840
  • Facility Phone: 203 842-2992
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: ELLEN H. DE MOLL
  • NPI Number: 1003644402
  • Taxonomy: 207N00000X - Dermatology

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CLIA Record

Field Name Field Value
CLIA Number 07D2317708
LAB Type Physician Office
Facility Name ELITE DERMATOLOGY PHYSICIANS
Street 38 EAST AVE
City NEW CANAAN
State CT
ZIP 06840
Phone 203 842-2992
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 1/30/2025
Certificate Expiration Date 1/29/2027
Facility Type Physician Office
Lab Director ELLEN H. DE MOLL

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