10D2315755 CLIA NUMBER - WALL DERMATOLOGY LLC

Laboratory Demographics

  • CLIA Code: 10D2315755
  • Facility Name: WALL DERMATOLOGY LLC
  • Facility Address: 1700 66TH ST N STE 300
    SAINT PETERSBURG, FL
    ZIP 33710
  • Facility Phone: 727 606-9255
  • Facility Type: Physician Office
  • Facility Type: Certificate of Compliance
  • Lab Director: WESTON B. WALL
  • NPI Number: 1003668328
  • Taxonomy: 207ND0101X - Dermatology

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CLIA Record

Field Name Field Value
CLIA Number 10D2315755
LAB Type Physician Office
Facility Name WALL DERMATOLOGY LLC
Street 1700 66TH ST N STE 300
City SAINT PETERSBURG
State FL
ZIP 33710
Phone 727 606-9255
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 6/6/2025
Certificate Expiration Date 6/5/2027
Facility Type Physician Office
Lab Director WESTON B. WALL

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