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25D2083928 CLIA NUMBER - PINE BELT DERMATOLOGY AND SKIN CANCER CENTER

Laboratory Demographics

CLIA Number: 25D2083928

Facility Name: PINE BELT DERMATOLOGY AND SKIN CANCER CENTER

Facility Address:
201 S MAIN STREET
PETAL, MS
ZIP 39465
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Facility Phone Number: 601 336-5626

Facility Type: Physician Office

Certificate Type: Certificate of Compliance
NPI Number: 1497159453

Taxonomy: 207ND0101X - Dermatology
The highly-trained surgeons that perform Mohs Micrographic Surgery are specialists both in dermatology and pathology. With their extensive knowledge of the skin and unique pathological skills, they are able to remove only diseased tissue, preserving healthy tissue and minimizing the cosmetic impact of the surgery. Mohs surgeons who belong to the American College of Mohs Surgery (ACMS) have completed a minimum of one year of fellowship training at one of the ACMS-approved training centers in the U.S.

CLIA Record

Field Name Field Value
CLIA Number 25D2083928
LAB Type Physician Office
Facility Name PINE BELT DERMATOLOGY AND SKIN CANCER CENTER
Street 201 S MAIN STREET
City PETAL
State MS
ZIP 39465
Phone 601 336-5626
CertificateType 2
CertificateEffectiveDate 2/16/2023
CertificateExpirationDate 2/15/2025
FacilityType Compliance

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