22D2251112 CLIA NUMBER - NORTHEAST DERMATOLOGY ASSOCIATES

Laboratory Demographics

  • CLIA Code: 22D2251112
  • Facility Name: NORTHEAST DERMATOLOGY ASSOCIATES
  • Facility Address: 1 WIDGER ROAD
    MARBLEHEAD, MA
    ZIP 01945
  • Facility Phone: (978) 691-5690
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: JENNA SHERIDAN
  • NPI Number: 1104921162
  • Taxonomy: 174400000X - Specialist

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CLIA Record

Field Name Field Value
CLIA Number 22D2251112
LAB Type Physician Office
Facility Name NORTHEAST DERMATOLOGY ASSOCIATES
Street 1 WIDGER ROAD
City MARBLEHEAD
State MA
ZIP 01945
Phone 9786915690
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 2/1/2026
Certificate Expiration Date 1/31/2028
Facility Type Physician Office
Lab Director JENNA SHERIDAN

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This page was last updated on: 5/18/2026