10D2123540 CLIA NUMBER - GREEN DERMATOLOGY & COSMETIC CENTER LLC

Laboratory Demographics

  • CLIA Code: 10D2123540
  • Facility Name: GREEN DERMATOLOGY & COSMETIC CENTER LLC
  • Facility Address: 260 SW NATURA AVE STE 101
    DEERFIELD BEACH, FL
    ZIP 33441
  • Facility Phone: 954 481-0650
  • Facility Type: Physician Office
  • Facility Type: Certificate of Compliance
  • Lab Director: DR. JASON BRADLEY GREEN
  • NPI Number: 1649726316
  • Taxonomy: 261QM2500X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 10D2123540
LAB Type Physician Office
Facility Name GREEN DERMATOLOGY & COSMETIC CENTER LLC
Street 260 SW NATURA AVE STE 101
City DEERFIELD BEACH
State FL
ZIP 33441
Phone 954 481-0650
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 2/27/2025
Certificate Expiration Date 2/26/2027
Facility Type Physician Office
Lab Director DR. JASON BRADLEY GREEN

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