10D2262186 CLIA NUMBER - PARADISE DERMATOLOGY LLC

Laboratory Demographics

  • CLIA Code: 10D2262186
  • Facility Name: PARADISE DERMATOLOGY LLC
  • Facility Address: 315 NOKOMIS AVE S
    VENICE, FL
    ZIP 34285
  • Facility Phone: 941 477-4007
  • Facility Type: Physician Office
  • Facility Type: Certificate of Compliance
  • Lab Director: MICHELLE PENNIE
  • NPI Number: 1689361644
  • Taxonomy: 207ND0101X - Dermatology

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CLIA Record

Field Name Field Value
CLIA Number 10D2262186
LAB Type Physician Office
Facility Name PARADISE DERMATOLOGY LLC
Street 315 NOKOMIS AVE S
City VENICE
State FL
ZIP 34285
Phone 941 477-4007
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 12/27/2024
Certificate Expiration Date 12/26/2026
Facility Type Physician Office
Lab Director MICHELLE PENNIE

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