25D2261584 CLIA NUMBER - NORTHSHORE DERMATOLOGY

Laboratory Demographics

  • CLIA Code: 25D2261584
  • Facility Name: NORTHSHORE DERMATOLOGY
  • Facility Address: 6353 HWY 11N
    PICAYUNE, MS
    ZIP 39466
  • Facility Phone: 601 749-9500
  • Facility Type: Physician Office
  • Facility Type: Certificate of Compliance
  • Lab Director: DR. DAVID PATE
  • NPI Number: 1194479725
  • Taxonomy: 207N00000X - Dermatology

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CLIA Record

Field Name Field Value
CLIA Number 25D2261584
LAB Type Physician Office
Facility Name NORTHSHORE DERMATOLOGY
Street 6353 HWY 11N
City PICAYUNE
State MS
ZIP 39466
Phone 601 749-9500
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 11/29/2024
Certificate Expiration Date 11/28/2026
Facility Type Physician Office
Lab Director DR. DAVID PATE

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