25D0993428 CLIA NUMBER - DERMATOLOGY ASSOCIATES LLC

Laboratory Demographics

CLIA Number: 25D0993428

Facility Name: DERMATOLOGY ASSOCIATES LLC

Facility Address:
501 MARSHALL STREET COLONNADES, SUITE 606
JACKSON, MS
ZIP 39202
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Facility Phone Number: 601 355-8555

Facility Type: Physician Office

Certificate Type: Certificate of Compliance

NPI Number: 1235318874

Taxonomy: 261QM2500X - Clinic/Center
An entity, facility, or distinct part of a facility providing diagnostic, treatment, and prescriptive services related to a specific area of medical specialization. Frequently used for Title V related Children's Specialty services or to meet specific public health needs (e.g., infectious diseases or breast and cervical cancer).

CLIA Record

Field Name	Field Value
CLIA Number	25D0993428
LAB Type	Physician Office
Facility Name	DERMATOLOGY ASSOCIATES LLC
Street	501 MARSHALL STREET COLONNADES, SUITE 606
City	JACKSON
State	MS
ZIP	39202
Phone	601 355-8555
CertificateType	2
CertificateEffectiveDate	4/21/2023
CertificateExpirationDate	4/20/2025
FacilityType	Compliance

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This page was last updated on: 4/23/2024