10D0722984 CLIA NUMBER - ADVANCED DERMATOLOGY AND COSMETIC SURGERY

Laboratory Demographics

  • CLIA Code: 10D0722984
  • Facility Name: ADVANCED DERMATOLOGY AND COSMETIC SURGERY
  • Facility Address: 1639 ATLANTIC BLVD STE 100
    JACKSONVILLE, FL
    ZIP 32207
  • Facility Phone: 407 284-3407
  • Facility Type: Physician Office
  • Facility Type: Certificate of Compliance
  • Lab Director: DR. JUAN CARLOS MARTINEZ
  • NPI Number: 1255754008
  • Taxonomy: 207N00000X - Dermatology

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CLIA Record

Field Name Field Value
CLIA Number 10D0722984
LAB Type Physician Office
Facility Name ADVANCED DERMATOLOGY AND COSMETIC SURGERY
Street 1639 ATLANTIC BLVD STE 100
City JACKSONVILLE
State FL
ZIP 32207
Phone 407 284-3407
Certificate Type Certificate of Compliance
Certificate Type Description This certificate is issued to a laboratory after an inspection that finds the laboratory to be in compliance with all applicable CLIA requirements.
Certificate Effective Date 10/28/2024
Certificate Expiration Date 10/27/2026
Facility Type Physician Office
Lab Director DR. JUAN CARLOS MARTINEZ

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This page was last updated on: 6/4/2025