42D2120471 CLIA NUMBER - UPSTATE DERMATOLOGY, PA

Laboratory Demographics

  • CLIA Code: 42D2120471
  • Facility Name: UPSTATE DERMATOLOGY, PA
  • Facility Address: 310 THE PARKWAY
    GREER, SC
    ZIP 29650
  • Facility Phone: 864 877-0776
  • Facility Type: Practitioner Other
  • Facility Type: Microscopy
  • Lab Director: JOHN B. KORMAN
  • NPI Number: 1306399860
  • Taxonomy: 207N00000X - Dermatology

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CLIA Record

Field Name Field Value
CLIA Number 42D2120471
LAB Type Practitioner Other
Facility Name UPSTATE DERMATOLOGY, PA
Street 310 THE PARKWAY
City GREER
State SC
ZIP 29650
Phone 864 877-0776
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 10/18/2024
Certificate Expiration Date 10/17/2026
Facility Type Practitioner Other
Lab Director JOHN B. KORMAN

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