39D2301108 CLIA NUMBER - LIVE OAK DERMATOLOGY PC

Laboratory Demographics

  • CLIA Code: 39D2301108
  • Facility Name: LIVE OAK DERMATOLOGY PC
  • Facility Address: 7176 WEST RIDGE ROAD
    FAIRVIEW, PA
    ZIP 16415
  • Facility Phone: 814 413-7997
  • Facility Type: Practitioner Other
  • Facility Type: Certificate of Compliance
  • Lab Director: DR. MICHAEL B. ZAYCOSKY
  • NPI Number: 1609654466
  • Taxonomy: 207ND0101X - Dermatology

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CLIA Record

Field Name Field Value
CLIA Number 39D2301108
LAB Type Practitioner Other
Facility Name LIVE OAK DERMATOLOGY PC
Street 7176 WEST RIDGE ROAD
City FAIRVIEW
State PA
ZIP 16415
Phone 814 413-7997
Certificate Type Certificate of Compliance
Certificate Type Description This certificate is issued to a laboratory after an inspection that finds the laboratory to be in compliance with all applicable CLIA requirements.
Certificate Effective Date 3/21/2024
Certificate Expiration Date 3/20/2026
Facility Type Practitioner Other
Lab Director DR. MICHAEL B. ZAYCOSKY

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This page was last updated on: 3/20/2025