08D2242833 CLIA NUMBER - COASTAL CARE AND DERMATOLOGY, LLC

Laboratory Demographics

CLIA Number: 08D2242833

Facility Name: COASTAL CARE AND DERMATOLOGY, LLC

Facility Address:
28467 DUPONT BLVD UNIT 6
MILLSBORO, DE
ZIP 19966
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Facility Phone Number: 302 542-4999

Facility Type: Physician Office

Certificate Type: Waiver

NPI Number: 1053838896

Taxonomy: 363L00000X - Nurse Practitioner
(1) A registered nurse provider with a graduate degree in nursing prepared for advanced practice involving independent and interdependent decision making and direct accountability for clinical judgment across the health care continuum or in a certified specialty. (2) A registered nurse who has completed additional training beyond basic nursing education and who provides primary health care services in accordance with state nurse practice laws or statutes. Tasks performed by nurse practitioners vary with practice requirements mandated by geographic, political, economic, and social factors. Nurse practitioner specialists include, but are not limited to, family nurse practitioners, gerontological nurse practitioners, pediatric nurse practitioners, obstetric-gynecologic nurse practitioners, and school nurse practitioners.

CLIA Record

Field Name	Field Value
CLIA Number	08D2242833
LAB Type	Physician Office
Facility Name	COASTAL CARE AND DERMATOLOGY, LLC
Street	28467 DUPONT BLVD UNIT 6
City	MILLSBORO
State	DE
ZIP	19966
Phone	302 542-4999
CertificateType	4
CertificateEffectiveDate	11/12/2023
CertificateExpirationDate	11/11/2025
FacilityType	Waiver

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This page was last updated on: 4/23/2024