49D0686618 CLIA NUMBER - PENINSULA DERMATOLOGY SKIN CANCER SURGERY CENTER

Laboratory Demographics

  • CLIA Code: 49D0686618
  • Facility Name: PENINSULA DERMATOLOGY SKIN CANCER SURGERY CENTER
  • Facility Address: 11844 ROCK LANDING DRIVE - SUITE B
    NEWPORT NEWS, VA
    ZIP 23606
  • Facility Phone: 757 873-0161
  • Facility Type: Physician Office
  • Facility Type: Certificate of Compliance
  • Lab Director: JASON D. MAZZURCO
  • NPI Number: 1134596224
  • Taxonomy: 251B00000X - Case Management

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CLIA Record

Field Name Field Value
CLIA Number 49D0686618
LAB Type Physician Office
Facility Name PENINSULA DERMATOLOGY SKIN CANCER SURGERY CENTER
Street 11844 ROCK LANDING DRIVE - SUITE B
City NEWPORT NEWS
State VA
ZIP 23606
Phone 757 873-0161
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 8/25/2025
Certificate Expiration Date 8/24/2027
Facility Type Physician Office
Lab Director JASON D. MAZZURCO

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