18D1065320 CLIA NUMBER - ADVANCED DERMATOLOGY, PSC

Laboratory Demographics

CLIA Number: 18D1065320

Facility Name: ADVANCED DERMATOLOGY, PSC

Facility Address:
715 SHAKER DRIVE, SUITE 132
LEXINGTON, KY
ZIP 40504
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Facility Phone Number: 859 288-5004

Facility Type: Physician Office

Certificate Type: Certificate of Compliance

NPI Number: 1558553560

Taxonomy: 261QM2500X - Clinic/Center
An entity, facility, or distinct part of a facility providing diagnostic, treatment, and prescriptive services related to a specific area of medical specialization. Frequently used for Title V related Children's Specialty services or to meet specific public health needs (e.g., infectious diseases or breast and cervical cancer).

CLIA Record

Field Name	Field Value
CLIA Number	18D1065320
LAB Type	Physician Office
Facility Name	ADVANCED DERMATOLOGY, PSC
Street	715 SHAKER DRIVE, SUITE 132
City	LEXINGTON
State	KY
ZIP	40504
Phone	859 288-5004
CertificateType	2
CertificateEffectiveDate	6/11/2023
CertificateExpirationDate	6/10/2025
FacilityType	Compliance

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