34D2157759 CLIA NUMBER - WAKE FOREST DERMATOLOGY

Laboratory Demographics

  • CLIA Code: 34D2157759
  • Facility Name: WAKE FOREST DERMATOLOGY
  • Facility Address: 2824 ROGERS ROAD SUITE 101
    WAKE FOREST, NC
    ZIP 27587
  • Facility Phone: 919 488-0355
  • Facility Type: Physician Office
  • Facility Type: Microscopy
  • Lab Director: PATRICIA A. MATHEIS
  • NPI Number: 1154565596
  • Taxonomy: 207N00000X - Dermatology

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CLIA Record

Field Name Field Value
CLIA Number 34D2157759
LAB Type Physician Office
Facility Name WAKE FOREST DERMATOLOGY
Street 2824 ROGERS ROAD SUITE 101
City WAKE FOREST
State NC
ZIP 27587
Phone 919 488-0355
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 11/13/2024
Certificate Expiration Date 11/12/2026
Facility Type Physician Office
Lab Director PATRICIA A. MATHEIS

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