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39D1002463 CLIA NUMBER - CENTER FOR DERMATOLOGY LASER & COSMETIC SURGERY

Laboratory Demographics

CLIA Number: 39D1002463

Facility Name: CENTER FOR DERMATOLOGY LASER & COSMETIC SURGERY

Facility Address:
204 MOSS PLAZA 9892 BUSTLETON AVENUE
PHILADELPHIA, PA
ZIP 19115
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Facility Phone Number: 215 676-2464

Facility Type: Physician Office

Certificate Type: Waiver
NPI Number: 1942340542

Taxonomy: 207N00000X - Dermatology
A dermatologist is trained to diagnose and treat pediatric and adult patients with benign and malignant disorders of the skin, mouth, external genitalia, hair and nails, as well as a number of sexually transmitted diseases. The dermatologist has had additional training and experience in the diagnosis and treatment of skin cancers, melanomas, moles and other tumors of the skin, the management of contact dermatitis and other allergic and nonallergic skin disorders, and in the recognition of the skin manifestations of systemic (including internal malignancy) and infectious diseases. Dermatologists have special training in dermatopathology and in the surgical techniques used in dermatology. They also have expertise in the management of cosmetic disorders of the skin such as hair loss and scars and the skin changes associated with aging.

CLIA Record

Field Name Field Value
CLIA Number 39D1002463
LAB Type Physician Office
Facility Name CENTER FOR DERMATOLOGY LASER & COSMETIC SURGERY
Street 204 MOSS PLAZA 9892 BUSTLETON AVENUE
City PHILADELPHIA
State PA
ZIP 19115
Phone 215 676-2464
CertificateType 4
CertificateEffectiveDate 8/7/2022
CertificateExpirationDate 8/6/2024
FacilityType Waiver

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