03D1011584 CLIA NUMBER - CAMELBACK DERMATOLOGY & SKIN SURGERY

Laboratory Demographics

  • CLIA Code: 03D1011584
  • Facility Name: CAMELBACK DERMATOLOGY & SKIN SURGERY
  • Facility Address: 4512 NORTH 40TH ST
    PHOENIX, AZ
    ZIP 85018
  • Facility Phone: 602 954-7546
  • Facility Type: Physician Office
  • Facility Type: Certificate of Compliance
  • Lab Director: AMENA DELUCA
  • NPI Number: 1225175441
  • Taxonomy: 207N00000X - Dermatology

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CLIA Record

Field Name Field Value
CLIA Number 03D1011584
LAB Type Physician Office
Facility Name CAMELBACK DERMATOLOGY & SKIN SURGERY
Street 4512 NORTH 40TH ST
City PHOENIX
State AZ
ZIP 85018
Phone 602 954-7546
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 3/10/2024
Certificate Expiration Date 3/9/2026
Facility Type Physician Office
Lab Director AMENA DELUCA

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