10D2216825 CLIA NUMBER - MARK T DAMERAU DMD PA

Laboratory Demographics

  • CLIA Code: 10D2216825
  • Facility Name: MARK T DAMERAU DMD PA
  • Facility Address: 400 VILLAGE SQ CROSSING - STE 1
    PALM BEACH GARDENS, FL
    ZIP 33410
  • Facility Phone: (561) 622-8988
  • Facility Type: Other - DENTAL OFFICE
  • Facility Type: Waiver
  • Lab Director: MARK T. DAMERAU
  • NPI Number: 1053433201
  • Taxonomy: 122300000X - Dentist

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CLIA Record

Field Name Field Value
CLIA Number 10D2216825
LAB Type Other - DENTAL OFFICE
Facility Name MARK T DAMERAU DMD PA
Street 400 VILLAGE SQ CROSSING - STE 1
City PALM BEACH GARDENS
State FL
ZIP 33410
Phone 5616228988
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 3/16/2025
Certificate Expiration Date 3/15/2027
Facility Type Other - DENTAL OFFICE
Lab Director MARK T. DAMERAU

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This page was last updated on: 5/18/2026