30D2258619 CLIA NUMBER - NORTHEAST DERMATOLOGY ASSOCIATES

Laboratory Demographics

  • CLIA Code: 30D2258619
  • Facility Name: NORTHEAST DERMATOLOGY ASSOCIATES
  • Facility Address: 75 GILCREAST RD
    LONDONDERRY, NH
    ZIP 03053
  • Facility Phone: 217 503-0983
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: DAVID GREENSTEIN
  • NPI Number: 1508061839
  • Taxonomy: 174400000X - Specialist

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CLIA Record

Field Name Field Value
CLIA Number 30D2258619
LAB Type Physician Office
Facility Name NORTHEAST DERMATOLOGY ASSOCIATES
Street 75 GILCREAST RD
City LONDONDERRY
State NH
ZIP 03053
Phone 217 503-0983
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 4/25/2024
Certificate Expiration Date 4/24/2026
Facility Type Physician Office
Lab Director DAVID GREENSTEIN

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