11D2120550 CLIA NUMBER - BELLA DERMATOLOGY

Laboratory Demographics

  • CLIA Code: 11D2120550
  • Facility Name: BELLA DERMATOLOGY
  • Facility Address: 2340 PATRICK HENRY PARKWAY, SUITE 200
    MCDONOUGH, GA
    ZIP 30253
  • Facility Phone: 770 507-8481
  • Facility Type: Physician Office
  • Facility Type: Microscopy
  • Lab Director: TERRY C. SHARPE
  • NPI Number: 1366700544
  • Taxonomy: 207N00000X - Dermatology

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CLIA Record

Field Name Field Value
CLIA Number 11D2120550
LAB Type Physician Office
Facility Name BELLA DERMATOLOGY
Street 2340 PATRICK HENRY PARKWAY, SUITE 200
City MCDONOUGH
State GA
ZIP 30253
Phone 770 507-8481
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 10/19/2024
Certificate Expiration Date 10/18/2026
Facility Type Physician Office
Lab Director TERRY C. SHARPE

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