11D1012945 CLIA NUMBER - CAMPEN DERMATOLOGY

Laboratory Demographics

  • CLIA Code: 11D1012945
  • Facility Name: CAMPEN DERMATOLOGY
  • Facility Address: 5102 PAULSEN STREET UNIT 1
    SAVANNAH, GA
    ZIP 31405
  • Facility Phone: 912 356-3604
  • Facility Type: Physician Office
  • Facility Type: Microscopy
  • Lab Director: REBECCA B. CAMPEN MD
  • NPI Number: 1336463876
  • Taxonomy: 207N00000X - Dermatology

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CLIA Record

Field Name Field Value
CLIA Number 11D1012945
LAB Type Physician Office
Facility Name CAMPEN DERMATOLOGY
Street 5102 PAULSEN STREET UNIT 1
City SAVANNAH
State GA
ZIP 31405
Phone 912 356-3604
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 5/27/2025
Certificate Expiration Date 5/26/2027
Facility Type Physician Office
Lab Director REBECCA B. CAMPEN MD

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