52D2275174 CLIA NUMBER - MCGOEY DERMATOLOGY, SC

Laboratory Demographics

CLIA Number: 52D2275174

Facility Name: MCGOEY DERMATOLOGY, SC

Facility Address:
832 MICHIGAN AVE
SHEBOYGAN, WI
ZIP 53081
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Facility Phone Number: 920 457-9634

Facility Type: Physician Office

Certificate Type: Certificate of Compliance

NPI Number: 1043951270

Taxonomy: 261QM2500X - Clinic/Center
An entity, facility, or distinct part of a facility providing diagnostic, treatment, and prescriptive services related to a specific area of medical specialization. Frequently used for Title V related Children's Specialty services or to meet specific public health needs (e.g., infectious diseases or breast and cervical cancer).

CLIA Record

Field Name	Field Value
CLIA Number	52D2275174
LAB Type	Physician Office
Facility Name	MCGOEY DERMATOLOGY, SC
Street	832 MICHIGAN AVE
City	SHEBOYGAN
State	WI
ZIP	53081
Phone	920 457-9634
CertificateType	2
CertificateEffectiveDate	10/4/2023
CertificateExpirationDate	10/3/2025
FacilityType	Compliance

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This page was last updated on: 4/23/2024