11D2004652 CLIA NUMBER - CENTER FOR DERMATOLOGY, LLC

Laboratory Demographics

  • CLIA Code: 11D2004652
  • Facility Name: CENTER FOR DERMATOLOGY, LLC
  • Facility Address: 721 WELLNESS WAY SUITE 210
    LAWRENCEVILLE, GA
    ZIP 30046
  • Facility Phone: 770 682-2500
  • Facility Type: Physician Office
  • Facility Type: Microscopy
  • Lab Director: ABDUL HAFEEZ
  • NPI Number: 1538396577
  • Taxonomy: 207NS0135X - Dermatology

Map and Directions

Get Directions

CLIA Record

Field Name Field Value
CLIA Number 11D2004652
LAB Type Physician Office
Facility Name CENTER FOR DERMATOLOGY, LLC
Street 721 WELLNESS WAY SUITE 210
City LAWRENCEVILLE
State GA
ZIP 30046
Phone 770 682-2500
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 3/10/2024
Certificate Expiration Date 3/9/2026
Facility Type Physician Office
Lab Director ABDUL HAFEEZ

Download Record

Download this CLIA record record in Text format: Export

Download this CLIA record record in Excel (CSV) format: Export

Download this CLIA record record in XML format: Export

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