49D2010181 CLIA NUMBER - COASTAL DERMATOLOGY

Laboratory Demographics

  • CLIA Code: 49D2010181
  • Facility Name: COASTAL DERMATOLOGY
  • Facility Address: 3176 HOLLAND ROAD - SUITE 103
    VIRGINIA BEACH, VA
    ZIP 23453
  • Facility Phone: 757 368-7546
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: KIMBERLY D. SODERBERG
  • NPI Number: 1730405879
  • Taxonomy: 207N00000X - Dermatology

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CLIA Record

Field Name Field Value
CLIA Number 49D2010181
LAB Type Physician Office
Facility Name COASTAL DERMATOLOGY
Street 3176 HOLLAND ROAD - SUITE 103
City VIRGINIA BEACH
State VA
ZIP 23453
Phone 757 368-7546
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 10/10/2023
Certificate Expiration Date 10/9/2025
Facility Type Physician Office
Lab Director KIMBERLY D. SODERBERG

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