10D2128465 CLIA NUMBER - DERMATOLOGY BOUTIQUE PA

Laboratory Demographics

  • CLIA Code: 10D2128465
  • Facility Name: DERMATOLOGY BOUTIQUE PA
  • Facility Address: 100 N FEDERAL HWY STE 202
    HALLANDALE, FL
    ZIP 33009
  • Facility Phone: 855 465-6621
  • Facility Type: Physician Office
  • Facility Type: Certificate of Compliance
  • Lab Director: DR. CYNTHIA A. GOLOMB
  • NPI Number: 1104225887
  • Taxonomy: 207N00000X - Dermatology

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CLIA Record

Field Name Field Value
CLIA Number 10D2128465
LAB Type Physician Office
Facility Name DERMATOLOGY BOUTIQUE PA
Street 100 N FEDERAL HWY STE 202
City HALLANDALE
State FL
ZIP 33009
Phone 855 465-6621
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 8/2/2025
Certificate Expiration Date 8/1/2027
Facility Type Physician Office
Lab Director DR. CYNTHIA A. GOLOMB

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