21D0680561 CLIA NUMBER - DERMATOLOGY & COSMETIC SURGERY ASSOC

Laboratory Demographics

CLIA Number: 21D0680561

Facility Name: DERMATOLOGY & COSMETIC SURGERY ASSOC

Facility Address:
7501 GREENBELT CENTER DR #1000
GREENBELT, MD
ZIP 20770
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Facility Phone Number: 301 345-7375

Facility Type: Physician Office

Certificate Type: Waiver

NPI Number: 1720196405

Taxonomy: 174400000X - Specialist
An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree.

CLIA Record

Field Name	Field Value
CLIA Number	21D0680561
LAB Type	Physician Office
Facility Name	DERMATOLOGY & COSMETIC SURGERY ASSOC
Street	7501 GREENBELT CENTER DR #1000
City	GREENBELT
State	MD
ZIP	20770
Phone	301 345-7375
CertificateType	4
CertificateEffectiveDate	4/5/2024
CertificateExpirationDate	4/4/2026
FacilityType	Waiver

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