11D0904401 CLIA NUMBER - DERMATOLOGY SPCECIALISTS OF GEORGIA, LLC

Laboratory Demographics

  • CLIA Code: 11D0904401
  • Facility Name: DERMATOLOGY SPCECIALISTS OF GEORGIA, LLC
  • Facility Address: 2550 WINDY HILL RD SUITE 220
    MARIETTA, GA
    ZIP 30067
  • Facility Phone: 850 252-4401
  • Facility Type: Physician Office
  • Facility Type: Certificate of Compliance
  • Lab Director: SPENCER D. HAWKINS
  • NPI Number: 1821115650
  • Taxonomy: 251E00000X - Home Health

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CLIA Record

Field Name Field Value
CLIA Number 11D0904401
LAB Type Physician Office
Facility Name DERMATOLOGY SPCECIALISTS OF GEORGIA, LLC
Street 2550 WINDY HILL RD SUITE 220
City MARIETTA
State GA
ZIP 30067
Phone 850 252-4401
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 11/11/2023
Certificate Expiration Date 11/10/2025
Facility Type Physician Office
Lab Director SPENCER D. HAWKINS

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