18D2311636 CLIA NUMBER - EQUITY DERMATOLOGY, PLL

Laboratory Demographics

  • CLIA Code: 18D2311636
  • Facility Name: EQUITY DERMATOLOGY, PLL
  • Facility Address: 1802 ROCKINGHAM AVE
    BOWLING GREEN, KY
    ZIP 42104
  • Facility Phone: 270 213-7777
  • Facility Type: Physician Office
  • Facility Type: Microscopy
  • Lab Director: DR. JAMES T. ALLRED
  • NPI Number: 1225855307
  • Taxonomy: 207N00000X - Dermatology

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CLIA Record

Field Name Field Value
CLIA Number 18D2311636
LAB Type Physician Office
Facility Name EQUITY DERMATOLOGY, PLL
Street 1802 ROCKINGHAM AVE
City BOWLING GREEN
State KY
ZIP 42104
Phone 270 213-7777
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 9/25/2024
Certificate Expiration Date 9/24/2026
Facility Type Physician Office
Lab Director DR. JAMES T. ALLRED

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