23D2262974 CLIA NUMBER - COASTAL DERMATOLOGY, PLC

Laboratory Demographics

  • CLIA Code: 23D2262974
  • Facility Name: COASTAL DERMATOLOGY, PLC
  • Facility Address: 954 BUSINESS PARK DRIVE SUITE 5
    TRAVERSE CITY, MI
    ZIP 49686
  • Facility Phone: 231 252-3200
  • Facility Type: Physician Office
  • Facility Type: Microscopy
  • Lab Director: PAULA CAHILL
  • NPI Number: 1275127722
  • Taxonomy: 207N00000X - Dermatology

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CLIA Record

Field Name Field Value
CLIA Number 23D2262974
LAB Type Physician Office
Facility Name COASTAL DERMATOLOGY, PLC
Street 954 BUSINESS PARK DRIVE SUITE 5
City TRAVERSE CITY
State MI
ZIP 49686
Phone 231 252-3200
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 6/21/2024
Certificate Expiration Date 6/20/2026
Facility Type Physician Office
Lab Director PAULA CAHILL

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