36D2004632 CLIA NUMBER - ENCORE DERMATOLOGY

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Laboratory Demographics

CLIA Number: 36D2004632

Facility Name: ENCORE DERMATOLOGY

Facility Address:
4900 GETTYSBURG ROAD
COLUMBUS, OH
ZIP 43220
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Facility Phone Number: 614 442-1012

Facility Type: Physician Office

Certificate Type: Microscopy

NPI Number: 1912220799

Taxonomy: 261QM2500X - Clinic/Center
An entity, facility, or distinct part of a facility providing diagnostic, treatment, and prescriptive services related to a specific area of medical specialization. Frequently used for Title V related Children's Specialty services or to meet specific public health needs (e.g., infectious diseases or breast and cervical cancer).

CLIA Record

Field Name	Field Value
CLIA Number	36D2004632
LAB Type	Physician Office
Facility Name	ENCORE DERMATOLOGY
Street	4900 GETTYSBURG ROAD
City	COLUMBUS
State	OH
ZIP	43220
Phone	614 442-1012
CertificateType	3
CertificateEffectiveDate	3/9/2024
CertificateExpirationDate	3/8/2026
FacilityType	PPMP

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This page was last updated on: 4/23/2024