10D2078624 CLIA NUMBER - CLEARLYDERM, LLC

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Laboratory Demographics

CLIA Number: 10D2078624

Facility Name: CLEARLYDERM, LLC

Facility Address:
22191 POWERLINE RD SUITE 29C
BOCA RATON, FL
ZIP 33433
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Facility Phone Number: 561 353-3376

Facility Type: Physician Office

Certificate Type: Certificate of Compliance

NPI Number: 1487947008

Taxonomy: 174400000X - Specialist
An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree.

CLIA Record

Field Name	Field Value
CLIA Number	10D2078624
LAB Type	Physician Office
Facility Name	CLEARLYDERM, LLC
Street	22191 POWERLINE RD SUITE 29C
City	BOCA RATON
State	FL
ZIP	33433
Phone	561 353-3376
CertificateType	2
CertificateEffectiveDate	10/25/2023
CertificateExpirationDate	10/24/2025
FacilityType	Compliance

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