30D0086191 CLIA NUMBER - NORTHEAST DERMATOLOGY ASSOCIATES, PC

Laboratory Demographics

  • CLIA Code: 30D0086191
  • Facility Name: NORTHEAST DERMATOLOGY ASSOCIATES, PC
  • Facility Address: 197 LOUDON RD
    CONCORD, NH
    ZIP 03301
  • Facility Phone: 603 224-2251
  • Facility Type: Physician Office
  • Facility Type: Microscopy
  • Lab Director: ANTHONY J. AVERSA
  • NPI Number: 1881817294
  • Taxonomy: 3336L0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 30D0086191
LAB Type Physician Office
Facility Name NORTHEAST DERMATOLOGY ASSOCIATES, PC
Street 197 LOUDON RD
City CONCORD
State NH
ZIP 03301
Phone 603 224-2251
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 10/19/2024
Certificate Expiration Date 10/18/2026
Facility Type Physician Office
Lab Director ANTHONY J. AVERSA

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