36D2004632 CLIA NUMBER - ENCORE DERMATOLOGY

Laboratory Demographics

  • CLIA Code: 36D2004632
  • Facility Name: ENCORE DERMATOLOGY
  • Facility Address: 4900 GETTYSBURG ROAD
    COLUMBUS, OH
    ZIP 43220
  • Facility Phone: 614 442-1012
  • Facility Type: Physician Office
  • Facility Type: Microscopy
  • Lab Director: GWYN R. LONDEREE
  • NPI Number: 1912220799
  • Taxonomy: 207N00000X - Dermatology

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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
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 3/9/2024
Certificate Expiration Date 3/8/2026
Facility Type Physician Office
Lab Director GWYN R. LONDEREE

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