10D2172515 CLIA NUMBER - MIDSTATE SKIN INSTITUTE LLC

Laboratory Demographics

  • CLIA Code: 10D2172515
  • Facility Name: MIDSTATE SKIN INSTITUTE LLC
  • Facility Address: 7550 SW 61ST AVE STE 1
    OCALA, FL
    ZIP 34476
  • Facility Phone: 352 512-0092
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: ASHLEY B. CAUTHEN
  • NPI Number: 1912258989
  • Taxonomy: 207N00000X - Dermatology

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CLIA Record

Field Name Field Value
CLIA Number 10D2172515
LAB Type Physician Office
Facility Name MIDSTATE SKIN INSTITUTE LLC
Street 7550 SW 61ST AVE STE 1
City OCALA
State FL
ZIP 34476
Phone 352 512-0092
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 9/24/2025
Certificate Expiration Date 9/23/2027
Facility Type Physician Office
Lab Director ASHLEY B. CAUTHEN

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