26D1098352 CLIA NUMBER - DERMATOLOGY OFFICE

Laboratory Demographics

  • CLIA Code: 26D1098352
  • Facility Name: DERMATOLOGY OFFICE
  • Facility Address: 1600 W HARPER
    POPLAR BLUFF, MO
    ZIP 63901
  • Facility Phone: 573 686-4750
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: HALEY MOSS
  • NPI Number: 1043462591
  • Taxonomy: 207N00000X - Dermatology

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CLIA Record

Field Name Field Value
CLIA Number 26D1098352
LAB Type Physician Office
Facility Name DERMATOLOGY OFFICE
Street 1600 W HARPER
City POPLAR BLUFF
State MO
ZIP 63901
Phone 573 686-4750
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 9/27/2024
Certificate Expiration Date 9/26/2026
Facility Type Physician Office
Lab Director HALEY MOSS

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