47D2199404 CLIA NUMBER - FOUR SEASON DERMATOLOGY

Laboratory Demographics

  • CLIA Code: 47D2199404
  • Facility Name: FOUR SEASON DERMATOLOGY
  • Facility Address: 354 MOUNTAIN VIEW DR, STE 300
    COLCHESTER, VT
    ZIP 05446
  • Facility Phone: 802 864-0192
  • Facility Type: Physician Office
  • Facility Type: Certificate of Compliance
  • Lab Director: GLENN D. GOLDMAN
  • NPI Number: 1790737393
  • Taxonomy: 207N00000X - Dermatology

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CLIA Record

Field Name Field Value
CLIA Number 47D2199404
LAB Type Physician Office
Facility Name FOUR SEASON DERMATOLOGY
Street 354 MOUNTAIN VIEW DR, STE 300
City COLCHESTER
State VT
ZIP 05446
Phone 802 864-0192
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 6/2/2025
Certificate Expiration Date 6/1/2027
Facility Type Physician Office
Lab Director GLENN D. GOLDMAN

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