10D2096188 CLIA NUMBER - ADVANCED DERMATOLOGY AND COSMETIC SURGERY

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Laboratory Demographics

CLIA Number: 10D2096188

Facility Name: ADVANCED DERMATOLOGY AND COSMETIC SURGERY

Facility Address:
484 US HWY 1 STE C
SEBASTIAN, FL
ZIP 32958
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Facility Phone Number: 407 284-3407

Facility Type: Physician Office

Certificate Type: Certificate of Compliance

NPI Number: 1750804357

Taxonomy: 111N00000X - Chiropractor
A provider qualified by a Doctor of Chiropractic (D.C.), licensed by the State and who practices chiropractic medicine -that discipline within the healing arts which deals with the nervous system and its relationship to the spinal column and its interrelationship with other body systems.

CLIA Record

Field Name	Field Value
CLIA Number	10D2096188
LAB Type	Physician Office
Facility Name	ADVANCED DERMATOLOGY AND COSMETIC SURGERY
Street	484 US HWY 1 STE C
City	SEBASTIAN
State	FL
ZIP	32958
Phone	407 284-3407
CertificateType	2
CertificateEffectiveDate	10/21/2023
CertificateExpirationDate	10/20/2025
FacilityType	Compliance

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