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PINE BELT DERMATOPATHOLOGY LAB, PA
NPI 1366269748
Dermatology - Dermatopathology in Petal, MS

Active since September 25, 2024CLIA 25D2278633 · Certificate of Compliance

NPPES record last updated: September 25, 2024. Verified against the NPPES registry weekly; last sync: August 16, 2026.

About Pine Belt Dermatopathology Lab, Pa NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

PINE BELT DERMATOPATHOLOGY LAB, PA (NPI 1366269748) is a healthcare organization registered as a dermatopathology in Petal, Mississippi and active in the NPI registry since September 2024. The organization holds a CLIA Certificate of Compliance certificate valid through November 19, 2027 and lists David Roy, Doctor/owner, as its authorized official.

NPPES Registry Identity

NPI1366269748
Entity TypeOrganization
Primary Taxonomy207ND0900X
Legal Business NamePINE BELT DERMATOPATHOLOGY LAB, PA
Location Address103 FORD DRPetal, MS 39465-2801
Mailing Address102 E Hospital DrHattiesburg, MS 39402-1310
Phone(601) 475-9968
Organization SubpartNo
Authorized OfficialDavid RoyDoctor/owner · (601) 475-9968
Enumeration DateSeptember 25, 2024
NPPES CertifiedSeptember 25, 2024
✔ NPI 1366269748 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDermatology · DermatopathologyAllopathic & Osteopathic Physicians
Taxonomy Code207ND0900X
Definition
A dermatopathologist has the expertise to diagnose and monitor diseases of the skin including infectious, immunologic, degenerative and neoplastic diseases. This entails the examination and interpretation of specially prepared tissue sections, cellular scrapings and smears of skin lesions by means of routine and special (electron and fluorescent) microscopes.
103 FORD DR, Petal, MS 39465
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Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Compliance 25D2278633

Pine Belt Dermatology Dermpath Lab · Petal, MS
Active · expires Nov 19, 2027
CLIA Number25D2278633
Laboratory TypePhysician Office
Certificate Effective DateNovember 20, 2025
Certificate Expiration DateNovember 19, 2027
Laboratory DirectorDr. David B. Roy
Laboratory Phone(601) 336-5626
Laboratory LocationPine Belt Dermatology Dermpath Lab103 Ford Dr Ste B, Petal, MS 39465
CLIA data matches this NPI record on: Address
This certificate is issued to a laboratory after an inspection that finds the laboratory to be in compliance with all applicable CLIA requirements.

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Pine Belt Dermatopathology Lab, PA's NPI number?

The NPI number for Pine Belt Dermatopathology Lab, PA is 1366269748. It was assigned to this organization in the NPPES registry on September 25, 2024.

Where is Pine Belt Dermatopathology Lab, PA located?

Pine Belt Dermatopathology Lab, PA is located at 103 Ford Dr, Petal, MS 39465. The listed phone number is (601) 475-9968.

What is Pine Belt Dermatopathology Lab, PA's specialty?

The primary specialty registered for this NPI is Dermatology, specializing in Dermatopathology, with taxonomy code 207ND0900X.

Does Pine Belt Dermatopathology Lab, PA hold a CLIA laboratory certificate?

Yes. A Certificate of Compliance (number 25D2278633) is associated with this NPI, valid through November 19, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Pine Belt Dermatopathology Lab, PA was last updated on September 25, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 22 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.