19D2164597 CLIA NUMBER - MATHERNE DERMATOLOGY, LLC

Laboratory Demographics

  • CLIA Code: 19D2164597
  • Facility Name: MATHERNE DERMATOLOGY, LLC
  • Facility Address: 101 PICCIOLA PARKWAY
    CUT OFF, LA
    ZIP 70345
  • Facility Phone: 985 446-5888
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: RYAN J. MATHERNE
  • NPI Number: 1548601016
  • Taxonomy: 207N00000X - Dermatology

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CLIA Record

Field Name Field Value
CLIA Number 19D2164597
LAB Type Physician Office
Facility Name MATHERNE DERMATOLOGY, LLC
Street 101 PICCIOLA PARKWAY
City CUT OFF
State LA
ZIP 70345
Phone 985 446-5888
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 4/10/2025
Certificate Expiration Date 4/9/2027
Facility Type Physician Office
Lab Director RYAN J. MATHERNE

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