16D2078554 CLIA NUMBER - DERMATOLOGY PC

Laboratory Demographics

  • CLIA Code: 16D2078554
  • Facility Name: DERMATOLOGY PC
  • Facility Address: 800 E 1ST STREET, SUITE 2900
    ANKENY, IA
    ZIP 50021
  • Facility Phone: 515 241-2000
  • Facility Type: Physician Office
  • Facility Type: Microscopy
  • Lab Director: JOSHUA B. WILSON
  • NPI Number: 1407955198
  • Taxonomy: 207N00000X - Dermatology

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CLIA Record

Field Name Field Value
CLIA Number 16D2078554
LAB Type Physician Office
Facility Name DERMATOLOGY PC
Street 800 E 1ST STREET, SUITE 2900
City ANKENY
State IA
ZIP 50021
Phone 515 241-2000
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 4/21/2025
Certificate Expiration Date 4/20/2027
Facility Type Physician Office
Lab Director JOSHUA B. WILSON

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