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21D1092736 CLIA NUMBER - FREDERICK DERMATOLOGY ASSOCIATES LLC

Laboratory Demographics

CLIA Number: 21D1092736

Facility Name: FREDERICK DERMATOLOGY ASSOCIATES LLC

Facility Address:
45 THOMAS JOHNSON DRIVE STE 209
FREDERICK, MD
ZIP 21702
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Facility Phone Number: 301 662-6755

Facility Type: Physician Office

Certificate Type: Certificate of Compliance
NPI Number: 1922493519

Taxonomy: 251S00000X - Community/Behavioral Health
A private or public agency usually under local government jurisdiction, responsible for assuring the delivery of community based mental health, intellectual disabilities, substance abuse and/or behavioral health services to individuals with those disabilities. Services may range from companion care, respite, transportation, community integration, crisis intervention and stabilization, supported employment, day support, prevocational services, residential support, therapeutic and supportive consultation, environmental modifications, intensive in-home therapy and day treatment, in addition to traditional mental health and behavioral treatment.

CLIA Record

Field Name Field Value
CLIA Number 21D1092736
LAB Type Physician Office
Facility Name FREDERICK DERMATOLOGY ASSOCIATES LLC
Street 45 THOMAS JOHNSON DRIVE STE 209
City FREDERICK
State MD
ZIP 21702
Phone 301 662-6755
CertificateType 2
CertificateEffectiveDate 2/3/2023
CertificateExpirationDate 2/2/2025
FacilityType Compliance

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