10D2308587 CLIA NUMBER - RISING SUN DERMATOLOGY, PLLC

Laboratory Demographics

  • CLIA Code: 10D2308587
  • Facility Name: RISING SUN DERMATOLOGY, PLLC
  • Facility Address: 665 STATE ROAD 207 SUITE 108
    SAINT AUGUSTINE, FL
    ZIP 32084
  • Facility Phone: 904 325-6165
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: SAMI K. SAIKALY
  • NPI Number: 1477337988
  • Taxonomy: 207N00000X - Dermatology

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CLIA Record

Field Name Field Value
CLIA Number 10D2308587
LAB Type Physician Office
Facility Name RISING SUN DERMATOLOGY, PLLC
Street 665 STATE ROAD 207 SUITE 108
City SAINT AUGUSTINE
State FL
ZIP 32084
Phone 904 325-6165
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 7/31/2024
Certificate Expiration Date 7/30/2026
Facility Type Physician Office
Lab Director SAMI K. SAIKALY

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