CLIA lab
CLIA 11D1073390: Peterson Dermatology
Vidalia, GA. Certificate and address details from the CMS Provider of Services file for clinical laboratories.
CLIA number 11D1073390 belongs to Peterson Dermatology in Vidalia, GA.
Certificate of Compliance, effective December 15, 2024, expires December 14, 2026.
Active in the CMS Provider of Services file posted October 16, 2026.
Source: CMS Provider of Services File, Clinical Laboratories (CLIA), as of October 16, 2026. Publisher page
Run it in Rivvi
Map your lab's test names to LOINC codes
Open in RivviFree to start. Opens Rivvi, the AI workspace for healthcare teams.
Certificate
- Certificate type
- Certificate of Compliance
- Certificate effective
- December 15, 2024
- Certificate expiration
- December 14, 2026
- Status in the CMS file
- Active (termination code 00)
- Original participation date
- September 1, 1992
- Facility type
- Physician office
- Ownership (control type)
- Proprietary
- Lab classification
- CLIA laboratory
Source: CMS Provider of Services File, Clinical Laboratories (CLIA), as of October 16, 2026. Publisher page
Lab and contact
- CLIA number
- 11D1073390
- Lab name
- Peterson Dermatology
- Address
- 305 First Street West, Vidalia, GA 30474
- Phone
- (912) 538-9080
- Fax
- (912) 538-9085
Annual test volume the lab reported
- Waived tests
- 30
- Provider-performed microscopy tests
- 300
- Other nonwaived tests
- 1,000
- Total
- 1,330
Volumes are what the lab reported to CMS on its CMS-116 application, as carried in the file.
Other labs in Vidalia, GA
- Affinis Hsopice, LLCCertificate of Waiver, Hospice11D2080786
- Air Evac EMS Inc - Ae 91Certificate of Waiver, Ambulance11D2016424
- Allergy & Asthma Clinic of SE GeorgiaCertificate of Accreditation, Physician office11D0885214
- Amedisys Ga, LLC D/B/A Amedisys Home HealthCertificate of Waiver, Home health agency11D0700797
- American Oncology Partners, PACertificate of Accreditation, Physician office11D2255260
- Amicita Home Health, LLCCertificate of Waiver, Home health agency11D0886833
- Anchored Minds Behavioral Health LLCCertificate of Waiver, Other practitioner11D2343287
- Bio-Medical Application of GeorgiaCertificate of Waiver, End stage renal disease dialysis facility11D1051451
- City Drug StoreCertificate of Waiver, Pharmacy11D0963277
- Cornerstone Phlebotomy ServicesCertificate of Waiver, Independent11D2305173
Related
Questions
What is the CLIA number for Peterson Dermatology in Vidalia?
11D1073390, per the CMS Provider of Services file posted October 16, 2026.
What CLIA certificate does Peterson Dermatology hold?
A Certificate of Compliance, according to the CMS file.
When does CLIA 11D1073390 expire?
The CMS file lists December 14, 2026 as the certificate expiration date; the certificate took effect December 15, 2024.