11D2004072 CLIA NUMBER - INTOWN DERMATOLOGY

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Laboratory Demographics

CLIA Number: 11D2004072

Facility Name: INTOWN DERMATOLOGY

Facility Address:
550 PEACHTREE STREET, SUITE 1110
ATLANTA, GA
ZIP 30308
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Facility Phone Number: 404 523-4223

Facility Type: Physician Office

Certificate Type: Certificate of Compliance

NPI Number: 1699800516

Taxonomy: 174400000X - Specialist
An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree.

CLIA Record

Field Name	Field Value
CLIA Number	11D2004072
LAB Type	Physician Office
Facility Name	INTOWN DERMATOLOGY
Street	550 PEACHTREE STREET, SUITE 1110
City	ATLANTA
State	GA
ZIP	30308
Phone	404 523-4223
CertificateType	2
CertificateEffectiveDate	9/16/2022
CertificateExpirationDate	9/15/2024
FacilityType	Compliance

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This page was last updated on: 4/23/2024