10D2218056 CLIA NUMBER - VITAL DERMATOLOGY LLC

Laboratory Demographics

  • CLIA Code: 10D2218056
  • Facility Name: VITAL DERMATOLOGY LLC
  • Facility Address: 6202 N 9TH AVE SUITE 2
    PENSACOLA, FL
    ZIP 32504
  • Facility Phone: 850 888-2424
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: JENNA M. BEASLEY
  • NPI Number: 1386289585
  • Taxonomy: 207N00000X - Dermatology

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CLIA Record

Field Name Field Value
CLIA Number 10D2218056
LAB Type Physician Office
Facility Name VITAL DERMATOLOGY LLC
Street 6202 N 9TH AVE SUITE 2
City PENSACOLA
State FL
ZIP 32504
Phone 850 888-2424
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 3/25/2025
Certificate Expiration Date 3/24/2027
Facility Type Physician Office
Lab Director JENNA M. BEASLEY

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