05D0558065 CLIA NUMBER - SKIN AND BEAUTY CENTER DBA NORTHRIDGE DERMATOLOGY ASSOCIATES

Laboratory Demographics

CLIA Number: 05D0558065

Facility Name: SKIN AND BEAUTY CENTER DBA NORTHRIDGE DERMATOLOGY ASSOCIATES

Facility Address:
9535 RESEDA BLVD STE 304
NORTHRIDGE, CA
ZIP 91324
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Facility Phone Number: 818 886-3884

Facility Type: Physician Office

Certificate Type: Certificate of Compliance

NPI Number: 1972920759

Taxonomy: 174400000X - Specialist
An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree.

CLIA Record

Field Name	Field Value
CLIA Number	05D0558065
LAB Type	Physician Office
Facility Name	SKIN AND BEAUTY CENTER DBA NORTHRIDGE DERMATOLOGY ASSOCIATES
Street	9535 RESEDA BLVD STE 304
City	NORTHRIDGE
State	CA
ZIP	91324
Phone	818 886-3884
CertificateType	2
CertificateEffectiveDate	6/30/2023
CertificateExpirationDate	6/29/2025
FacilityType	Compliance

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This page was last updated on: 4/23/2024