25D0319343 CLIA NUMBER - TULANE DERMATOLOGY AFFILIATES - GULF COAST P A

Laboratory Demographics

  • CLIA Code: 25D0319343
  • Facility Name: TULANE DERMATOLOGY AFFILIATES - GULF COAST P A
  • Facility Address: 1245 42ND AVENUE
    GULFPORT, MS
    ZIP 39501
  • Facility Phone: 228 864-8049
  • Facility Type: Physician Office
  • Facility Type: Certificate of Compliance
  • Lab Director: ALAN LEWIS
  • NPI Number: 1821285438
  • Taxonomy: 207N00000X - Dermatology

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CLIA Record

Field Name Field Value
CLIA Number 25D0319343
LAB Type Physician Office
Facility Name TULANE DERMATOLOGY AFFILIATES - GULF COAST P A
Street 1245 42ND AVENUE
City GULFPORT
State MS
ZIP 39501
Phone 228 864-8049
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 1/25/2025
Certificate Expiration Date 1/24/2027
Facility Type Physician Office
Lab Director ALAN LEWIS

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