25D2054572 CLIA NUMBER - ADVANCED DERMATOLOGY & SKIN CANCER ASSOCIATES PLLC

Laboratory Demographics

  • CLIA Code: 25D2054572
  • Facility Name: ADVANCED DERMATOLOGY & SKIN CANCER ASSOCIATES PLLC
  • Facility Address: 7203 GOODMAN RD
    OLIVE BRANCH, MS
    ZIP 38654
  • Facility Phone: 901 759-2322
  • Facility Type: Physician Office
  • Facility Type: Certificate of Compliance
  • Lab Director: DR. PURVISHA J. PATEL
  • NPI Number: 1467728006
  • Taxonomy: 261QP2000X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 25D2054572
LAB Type Physician Office
Facility Name ADVANCED DERMATOLOGY & SKIN CANCER ASSOCIATES PLLC
Street 7203 GOODMAN RD
City OLIVE BRANCH
State MS
ZIP 38654
Phone 901 759-2322
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 9/26/2025
Certificate Expiration Date 9/25/2027
Facility Type Physician Office
Lab Director DR. PURVISHA J. PATEL

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