33D1031432 CLIA NUMBER - KENNETH MARK MD PC

Laboratory Demographics

  • CLIA Code: 33D1031432
  • Facility Name: KENNETH MARK MD PC
  • Facility Address: 425 COUNTY ROAD 39A, SUITE 201
    SOUTHAMPTON, NY
    ZIP 11968
  • Facility Phone: 631 283-0002
  • Facility Type: Physician Office
  • Facility Type: Certificate of Compliance
  • Lab Director: DR. KENNETH A. MARK
  • NPI Number: 1538199310
  • Taxonomy: 207ND0101X - Dermatology

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CLIA Record

Field Name Field Value
CLIA Number 33D1031432
LAB Type Physician Office
Facility Name KENNETH MARK MD PC
Street 425 COUNTY ROAD 39A, SUITE 201
City SOUTHAMPTON
State NY
ZIP 11968
Phone 631 283-0002
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 5/22/2024
Certificate Expiration Date 5/21/2026
Facility Type Physician Office
Lab Director DR. KENNETH A. MARK

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This page was last updated on: 6/4/2025