11D2165927 CLIA NUMBER - SOUTHEAST DERMATOLOGY SPECIALISTS

Laboratory Demographics

CLIA Number: 11D2165927

Facility Name: SOUTHEAST DERMATOLOGY SPECIALISTS

Facility Address:
400 BROOKSTONE PARKWAY, SUITE 500
COLUMBUS, GA
ZIP 31904
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Facility Phone Number: 706 568-2700

Facility Type: Physician Office

Certificate Type: Certificate of Compliance

NPI Number: 1730501735

Taxonomy: 207RP1001X - Internal Medicine
An internist who treats diseases of the lungs and airways. The pulmonologist diagnoses and treats cancer, pneumonia, pleurisy, asthma, occupational and environmental diseases, bronchitis, sleep disorders, emphysema and other complex disorders of the lungs.

CLIA Record

Field Name	Field Value
CLIA Number	11D2165927
LAB Type	Physician Office
Facility Name	SOUTHEAST DERMATOLOGY SPECIALISTS
Street	400 BROOKSTONE PARKWAY, SUITE 500
City	COLUMBUS
State	GA
ZIP	31904
Phone	706 568-2700
CertificateType	2
CertificateEffectiveDate	2/13/2024
CertificateExpirationDate	2/12/2026
FacilityType	Compliance

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