33D2295405 CLIA NUMBER - ELEVATE DERMATOLOGY, PC

Laboratory Demographics

  • CLIA Code: 33D2295405
  • Facility Name: ELEVATE DERMATOLOGY, PC
  • Facility Address: 66 COMMACK ROAD, SUITE 200
    COMMACK, NY
    ZIP 11725
  • Facility Phone: 631 481-7470
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: DR. TAMARA KOSS
  • NPI Number: 1932880788
  • Taxonomy: 207N00000X - Dermatology

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CLIA Record

Field Name Field Value
CLIA Number 33D2295405
LAB Type Physician Office
Facility Name ELEVATE DERMATOLOGY, PC
Street 66 COMMACK ROAD, SUITE 200
City COMMACK
State NY
ZIP 11725
Phone 631 481-7470
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 12/12/2023
Certificate Expiration Date 12/11/2025
Facility Type Physician Office
Lab Director DR. TAMARA KOSS

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