14D0434047 CLIA NUMBER - DISTINCTIVE DERMATOLOGY

Laboratory Demographics

  • CLIA Code: 14D0434047
  • Facility Name: DISTINCTIVE DERMATOLOGY
  • Facility Address: 390 OFFICE CT
    FAIRVIEW HEIGHTS, IL
    ZIP 62208
  • Facility Phone: (618) 233-7666
  • Facility Type: Physician Office
  • Facility Type: Certificate of Compliance
  • Lab Director: ANGELA M. SUTTON
  • NPI Number: 1518028398
  • Taxonomy: 207N00000X - Dermatology

Map and Directions

Get Directions

CLIA Record

Field Name Field Value
CLIA Number 14D0434047
LAB Type Physician Office
Facility Name DISTINCTIVE DERMATOLOGY
Street 390 OFFICE CT
City FAIRVIEW HEIGHTS
State IL
ZIP 62208
Phone 6182337666
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 10/30/2024
Certificate Expiration Date 10/29/2026
Facility Type Physician Office
Lab Director ANGELA M. SUTTON

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: 5/18/2026