26D2171419 CLIA NUMBER - COLUMBIA DERMATOLOGY AND COSMETIC SURGERY, LLC

Laboratory Demographics

  • CLIA Code: 26D2171419
  • Facility Name: COLUMBIA DERMATOLOGY AND COSMETIC SURGERY, LLC
  • Facility Address: 204 NORTH KEENE STREET, SUITE 100
    COLUMBIA, MO
    ZIP 65201
  • Facility Phone: 573 442-2961
  • Facility Type: Physician Office
  • Facility Type: Microscopy
  • Lab Director: KAITLIN A. SCHIAVO
  • NPI Number: 1144609918
  • Taxonomy: 174400000X - Specialist

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CLIA Record

Field Name Field Value
CLIA Number 26D2171419
LAB Type Physician Office
Facility Name COLUMBIA DERMATOLOGY AND COSMETIC SURGERY, LLC
Street 204 NORTH KEENE STREET, SUITE 100
City COLUMBIA
State MO
ZIP 65201
Phone 573 442-2961
Certificate Type Certificate for Provider-Performed Microscopy Procedures (PPMP)
Certificate Type Description This certificate is issued to a laboratory in which a physician, midlevel practitioner or dentist performs no tests other than the microscopy procedures. This certificate permits the laboratory to also perform waived tests.
Certificate Effective Date 8/29/2023
Certificate Expiration Date 8/28/2025
Facility Type Physician Office
Lab Director KAITLIN A. SCHIAVO

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This page was last updated on: 3/20/2025