10D0989872 CLIA NUMBER - DERMATOLOGY GROUP PA,THE

Laboratory Demographics

  • CLIA Code: 10D0989872
  • Facility Name: DERMATOLOGY GROUP PA,THE
  • Facility Address: 515 WEST SR 434 STE 210
    LONGWOOD, FL
    ZIP 32750
  • Facility Phone: 407 332-8080
  • Facility Type: Physician Office
  • Facility Type: Certificate of Compliance
  • Lab Director: DR. MICHAEL S. HENNER
  • NPI Number: 1356300081
  • Taxonomy: 174400000X - Specialist

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CLIA Record

Field Name Field Value
CLIA Number 10D0989872
LAB Type Physician Office
Facility Name DERMATOLOGY GROUP PA,THE
Street 515 WEST SR 434 STE 210
City LONGWOOD
State FL
ZIP 32750
Phone 407 332-8080
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 6/1/2024
Certificate Expiration Date 5/31/2026
Facility Type Physician Office
Lab Director DR. MICHAEL S. HENNER

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