11D0264795 CLIA NUMBER - SAVANNAH DERMATOLOGY CLINIC

Laboratory Demographics

  • CLIA Code: 11D0264795
  • Facility Name: SAVANNAH DERMATOLOGY CLINIC
  • Facility Address: 712 EAST 70TH ST
    SAVANNAH, GA
    ZIP 31405
  • Facility Phone: 912 352-8974
  • Facility Type: Physician Office
  • Facility Type: Microscopy
  • Lab Director: MARTIN S. PRITZKER MD
  • NPI Number: 1649394065
  • Taxonomy: 174400000X - Specialist

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CLIA Record

Field Name Field Value
CLIA Number 11D0264795
LAB Type Physician Office
Facility Name SAVANNAH DERMATOLOGY CLINIC
Street 712 EAST 70TH ST
City SAVANNAH
State GA
ZIP 31405
Phone 912 352-8974
Certificate Type Certificate for Provider-Performed Microscopy Procedures (PPMP)
Certificate Type Description This certificate is issued to a laboratory in which a physician, midlevel practitioner or dentist performs no tests other than the microscopy procedures. This certificate permits the laboratory to also perform waived tests.
Certificate Effective Date 9/1/2024
Certificate Expiration Date 8/31/2026
Facility Type Physician Office
Lab Director MARTIN S. PRITZKER MD

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