22D1014691 CLIA NUMBER - INTEGRATIVE DERMATOLOGY, PC

Laboratory Demographics

  • CLIA Code: 22D1014691
  • Facility Name: INTEGRATIVE DERMATOLOGY, PC
  • Facility Address: 1172 BEACON ST, SUITE 402
    NEWTON, MA
    ZIP 02461
  • Facility Phone: 617 558-5580
  • Facility Type: Physician Office
  • Facility Type: Microscopy
  • Lab Director: VALORI TRELOAR
  • NPI Number: 1154522860
  • Taxonomy: 207N00000X - Dermatology

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CLIA Record

Field Name Field Value
CLIA Number 22D1014691
LAB Type Physician Office
Facility Name INTEGRATIVE DERMATOLOGY, PC
Street 1172 BEACON ST, SUITE 402
City NEWTON
State MA
ZIP 02461
Phone 617 558-5580
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 7/15/2025
Certificate Expiration Date 7/14/2027
Facility Type Physician Office
Lab Director VALORI TRELOAR

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