21D2175030 CLIA NUMBER - ADVANCED DERMATOLOGY OF MARYLAND

Laboratory Demographics

  • CLIA Code: 21D2175030
  • Facility Name: ADVANCED DERMATOLOGY OF MARYLAND
  • Facility Address: 101 CENTENNIAL STREET #H
    LA PLATA, MD
    ZIP 20646
  • Facility Phone: 407 284-3407
  • Facility Type: Physician Office
  • Facility Type: Certificate of Compliance
  • Lab Director: DR. SEBASTIAN S. DEMARCO
  • NPI Number: 1124445036
  • Taxonomy: 207ZP0102X - Pathology

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CLIA Record

Field Name Field Value
CLIA Number 21D2175030
LAB Type Physician Office
Facility Name ADVANCED DERMATOLOGY OF MARYLAND
Street 101 CENTENNIAL STREET #H
City LA PLATA
State MD
ZIP 20646
Phone 407 284-3407
Certificate Type Certificate of Compliance
Certificate Type Description This certificate is issued to a laboratory after an inspection that finds the laboratory to be in compliance with all applicable CLIA requirements.
Certificate Effective Date 3/15/2024
Certificate Expiration Date 3/14/2026
Facility Type Physician Office
Lab Director DR. SEBASTIAN S. DEMARCO

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This page was last updated on: 6/4/2025