52D2106871 CLIA NUMBER - NEW DERMATOLOGY GROUP LTD

Laboratory Demographics

  • CLIA Code: 52D2106871
  • Facility Name: NEW DERMATOLOGY GROUP LTD
  • Facility Address: 2360 DUCK CREEK PKWY ROOM 203
    GREEN BAY, WI
    ZIP 54303
  • Facility Phone: 920 965-0345
  • Facility Type: Physician Office
  • Facility Type: Certificate of Compliance
  • Lab Director: DR. KEVAN G. LEWIS
  • NPI Number: 1356784334
  • Taxonomy: 207N00000X - Dermatology

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CLIA Record

Field Name Field Value
CLIA Number 52D2106871
LAB Type Physician Office
Facility Name NEW DERMATOLOGY GROUP LTD
Street 2360 DUCK CREEK PKWY ROOM 203
City GREEN BAY
State WI
ZIP 54303
Phone 920 965-0345
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 4/20/2024
Certificate Expiration Date 4/19/2026
Facility Type Physician Office
Lab Director DR. KEVAN G. LEWIS

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