23D2280231 CLIA NUMBER - MODERN DERMATOLOGY, PLLC

Laboratory Demographics

  • CLIA Code: 23D2280231
  • Facility Name: MODERN DERMATOLOGY, PLLC
  • Facility Address: 58851 VAN DYKE ROAD SUITE 100
    WASHINGTON, MI
    ZIP 48094
  • Facility Phone: 248 375-4033
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: MARIANA AFANAJOVSKI
  • NPI Number: 1750967691
  • Taxonomy: 207N00000X - Dermatology

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CLIA Record

Field Name Field Value
CLIA Number 23D2280231
LAB Type Physician Office
Facility Name MODERN DERMATOLOGY, PLLC
Street 58851 VAN DYKE ROAD SUITE 100
City WASHINGTON
State MI
ZIP 48094
Phone 248 375-4033
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 4/17/2025
Certificate Expiration Date 4/16/2027
Facility Type Physician Office
Lab Director MARIANA AFANAJOVSKI

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