03D1079908 CLIA NUMBER - CENTER FOR DERMATOLOGY & PLASTIC SURGERY DESERT RIDGE

Laboratory Demographics

  • CLIA Code: 03D1079908
  • Facility Name: CENTER FOR DERMATOLOGY & PLASTIC SURGERY DESERT RIDGE
  • Facility Address: 20940 NORTH TATUM BLVD STE 200
    PHOENIX, AZ
    ZIP 85050
  • Facility Phone: 480 905-8485
  • Facility Type: Physician Office
  • Facility Type: Certificate of Compliance
  • Lab Director: JEFFREY KRASE
  • NPI Number: 1194792416
  • Taxonomy: 207N00000X - Dermatology

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CLIA Record

Field Name Field Value
CLIA Number 03D1079908
LAB Type Physician Office
Facility Name CENTER FOR DERMATOLOGY & PLASTIC SURGERY DESERT RIDGE
Street 20940 NORTH TATUM BLVD STE 200
City PHOENIX
State AZ
ZIP 85050
Phone 480 905-8485
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 3/11/2025
Certificate Expiration Date 3/10/2027
Facility Type Physician Office
Lab Director JEFFREY KRASE

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