31D1063332 CLIA NUMBER - ADVANCED DERMATOLOGY & SKIN SURGERY PC

Laboratory Demographics

  • CLIA Code: 31D1063332
  • Facility Name: ADVANCED DERMATOLOGY & SKIN SURGERY PC
  • Facility Address: 456 CHESTNUT STREET SUITE 201
    LAKEWOOD, NJ
    ZIP 08701
  • Facility Phone: 732 905-9200
  • Facility Type: Physician Office
  • Facility Type: Certificate of Compliance
  • Lab Director: MORDECHAI M. TARLOW
  • NPI Number: 1023044724
  • Taxonomy: 207N00000X - Dermatology

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CLIA Record

Field Name Field Value
CLIA Number 31D1063332
LAB Type Physician Office
Facility Name ADVANCED DERMATOLOGY & SKIN SURGERY PC
Street 456 CHESTNUT STREET SUITE 201
City LAKEWOOD
State NJ
ZIP 08701
Phone 732 905-9200
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 5/14/2025
Certificate Expiration Date 5/13/2027
Facility Type Physician Office
Lab Director MORDECHAI M. TARLOW

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