10D2107105 CLIA NUMBER - INDIGO DERMATOLOGY LLC

Laboratory Demographics

  • CLIA Code: 10D2107105
  • Facility Name: INDIGO DERMATOLOGY LLC
  • Facility Address: 675 S BABCOCK ST
    MELBOURNE, FL
    ZIP 32901
  • Facility Phone: 321 951-1010
  • Facility Type: Physician Office
  • Facility Type: Certificate of Compliance
  • Lab Director: SUMEET K. THAREJA
  • NPI Number: 1659743094
  • Taxonomy: 174400000X - Specialist

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CLIA Record

Field Name Field Value
CLIA Number 10D2107105
LAB Type Physician Office
Facility Name INDIGO DERMATOLOGY LLC
Street 675 S BABCOCK ST
City MELBOURNE
State FL
ZIP 32901
Phone 321 951-1010
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 12/20/2024
Certificate Expiration Date 12/19/2026
Facility Type Physician Office
Lab Director SUMEET K. THAREJA

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