08D0682019 CLIA NUMBER - PREMIER DERMATOLOGY AND COSMETIC SURGERY

Laboratory Demographics

  • CLIA Code: 08D0682019
  • Facility Name: PREMIER DERMATOLOGY AND COSMETIC SURGERY
  • Facility Address: 800 DELAWARE AVE 3RD FLOOR
    WILMINGTON, DE
    ZIP 19801
  • Facility Phone: 302 633-7550
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: DR. MATTHEW R. HANSON
  • NPI Number: 1104270834
  • Taxonomy: 363AM0700X - Physician Assistant

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CLIA Record

Field Name Field Value
CLIA Number 08D0682019
LAB Type Physician Office
Facility Name PREMIER DERMATOLOGY AND COSMETIC SURGERY
Street 800 DELAWARE AVE 3RD FLOOR
City WILMINGTON
State DE
ZIP 19801
Phone 302 633-7550
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 9/1/2024
Certificate Expiration Date 8/31/2026
Facility Type Physician Office
Lab Director DR. MATTHEW R. HANSON

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