03D2011938 CLIA NUMBER - NORTH MOUNTAIN DERMATOLOGY

Laboratory Demographics

  • CLIA Code: 03D2011938
  • Facility Name: NORTH MOUNTAIN DERMATOLOGY
  • Facility Address: 9250 N 3RD ST #3025
    PHOENIX, AZ
    ZIP 85020
  • Facility Phone: 602 944-4628
  • Facility Type: Physician Office
  • Facility Type: Microscopy
  • Lab Director: RAJIV KWATRA
  • NPI Number: 1730293432
  • Taxonomy: 207N00000X - Dermatology

Map and Directions

Get Directions

CLIA Record

Field Name Field Value
CLIA Number 03D2011938
LAB Type Physician Office
Facility Name NORTH MOUNTAIN DERMATOLOGY
Street 9250 N 3RD ST #3025
City PHOENIX
State AZ
ZIP 85020
Phone 602 944-4628
Certificate Type Certificate for Provider-Performed Microscopy Procedures (PPMP)
Certificate Type Description This certificate is issued to a laboratory in which a physician, midlevel practitioner or dentist performs no tests other than the microscopy procedures. This certificate permits the laboratory to also perform waived tests.
Certificate Effective Date 2/18/2024
Certificate Expiration Date 2/17/2026
Facility Type Physician Office
Lab Director RAJIV KWATRA

Download Record

Download this CLIA record record in Text format: Export

Download this CLIA record record in Excel (CSV) format: Export

Download this CLIA record record in XML format: Export

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