03D2011524 CLIA NUMBER - MACKENZIE DERMATOLOGY

Laboratory Demographics

  • CLIA Code: 03D2011524
  • Facility Name: MACKENZIE DERMATOLOGY
  • Facility Address: 3190 CLEARWATER DR
    PRESCOTT, AZ
    ZIP 86305
  • Facility Phone: 928 541-1312
  • Facility Type: Physician Office
  • Facility Type: Certificate of Compliance
  • Lab Director: KEITH MACKENZIE
  • NPI Number: 1396971958
  • Taxonomy: 207NS0135X - Dermatology

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CLIA Record

Field Name Field Value
CLIA Number 03D2011524
LAB Type Physician Office
Facility Name MACKENZIE DERMATOLOGY
Street 3190 CLEARWATER DR
City PRESCOTT
State AZ
ZIP 86305
Phone 928 541-1312
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 10/29/2023
Certificate Expiration Date 10/28/2025
Facility Type Physician Office
Lab Director KEITH MACKENZIE

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