10D2315689 CLIA NUMBER - WATERSIDE DERMATOLOGY PLLC

Laboratory Demographics

  • CLIA Code: 10D2315689
  • Facility Name: WATERSIDE DERMATOLOGY PLLC
  • Facility Address: 5959 17TH AVE W
    BRADENTON, FL
    ZIP 34209
  • Facility Phone: 941 748-3376
  • Facility Type: Physician Office
  • Facility Type: Certificate of Compliance
  • Lab Director: RICHARD DEGREGORIO
  • NPI Number: 1639856297
  • Taxonomy: 207N00000X - Dermatology

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CLIA Record

Field Name Field Value
CLIA Number 10D2315689
LAB Type Physician Office
Facility Name WATERSIDE DERMATOLOGY PLLC
Street 5959 17TH AVE W
City BRADENTON
State FL
ZIP 34209
Phone 941 748-3376
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 12/17/2024
Certificate Expiration Date 12/16/2026
Facility Type Physician Office
Lab Director RICHARD DEGREGORIO

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