10D1043854 CLIA NUMBER - BAY AREA SKIN CANCER SURGERY AND DERMATOLOGY LLC

Laboratory Demographics

CLIA Number: 10D1043854

Facility Name: BAY AREA SKIN CANCER SURGERY AND DERMATOLOGY LLC

Facility Address:
702 MANATEE AVE W
BRADENTON, FL
ZIP 34205
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Facility Phone Number: 941 748-4747

Facility Type: Physician Office

Certificate Type: Certificate of Compliance

NPI Number: 1437347556

Taxonomy: 261Q00000X - Clinic/Center
A facility or distinct part of one used for the diagnosis and treatment of outpatients. Clinic/Center is irregularly defined, sometimes being limited to organizations serving specialized treatment requirements or distinct patient/client groups (e.g., radiology, poor, and public health).

CLIA Record

Field Name	Field Value
CLIA Number	10D1043854
LAB Type	Physician Office
Facility Name	BAY AREA SKIN CANCER SURGERY AND DERMATOLOGY LLC
Street	702 MANATEE AVE W
City	BRADENTON
State	FL
ZIP	34205
Phone	941 748-4747
CertificateType	2
CertificateEffectiveDate	9/21/2023
CertificateExpirationDate	9/20/2025
FacilityType	Compliance

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