10D2228544 CLIA NUMBER - MID-FLORIDA DERMATOLOGY ASSOCIATES CLEAR CHOICE DERMATOLOGY OF FL

Laboratory Demographics

  • CLIA Code: 10D2228544
  • Facility Name: MID-FLORIDA DERMATOLOGY ASSOCIATES CLEAR CHOICE DERMATOLOGY OF FL
  • Facility Address: 1255 STATE RD 60 EAST STE 100
    LAKE WALES, FL
    ZIP 33853
  • Facility Phone: 863 589-5685
  • Facility Type: Physician Office
  • Facility Type: Certificate of Compliance
  • Lab Director: RAYMOND R. KNISLEY
  • NPI Number: 1982357992
  • Taxonomy: 103K00000X - Behavior Analyst

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CLIA Record

Field Name Field Value
CLIA Number 10D2228544
LAB Type Physician Office
Facility Name MID-FLORIDA DERMATOLOGY ASSOCIATES CLEAR CHOICE DERMATOLOGY OF FL
Street 1255 STATE RD 60 EAST STE 100
City LAKE WALES
State FL
ZIP 33853
Phone 863 589-5685
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 4/12/2024
Certificate Expiration Date 4/11/2026
Facility Type Physician Office
Lab Director RAYMOND R. KNISLEY

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