11D2147186 CLIA NUMBER - LDC DERMATOPATHOLOGY, LLC

Laboratory Demographics

  • CLIA Code: 11D2147186
  • Facility Name: LDC DERMATOPATHOLOGY, LLC
  • Facility Address: 2380 LAKEFRONT COURT
    MARIETTA, GA
    ZIP 30062
  • Facility Phone: 614 273-5705
  • Facility Type: Physician Office
  • Facility Type: Certificate of Compliance
  • Lab Director: LYNN D. COOPER
  • NPI Number: 1114363207
  • Taxonomy: 291U00000X - Clinical Medical Laboratory

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CLIA Record

Field Name Field Value
CLIA Number 11D2147186
LAB Type Physician Office
Facility Name LDC DERMATOPATHOLOGY, LLC
Street 2380 LAKEFRONT COURT
City MARIETTA
State GA
ZIP 30062
Phone 614 273-5705
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 4/9/2025
Certificate Expiration Date 4/8/2027
Facility Type Physician Office
Lab Director LYNN D. COOPER

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