05D0573825 CLIA NUMBER - ADVANCED DERMATOLOGY & LASER CENTER OF REDLANDS

Laboratory Demographics

  • CLIA Code: 05D0573825
  • Facility Name: ADVANCED DERMATOLOGY & LASER CENTER OF REDLANDS
  • Facility Address: 255 TERRACINA BLVD STE 206
    REDLANDS, CA
    ZIP 92373
  • Facility Phone: 909 792-8600
  • Facility Type: Physician Office
  • Facility Type: Certificate of Compliance
  • Lab Director: FRED F. SOEPRONO MD
  • NPI Number: 1346441276
  • Taxonomy: 207N00000X - Dermatology

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CLIA Record

Field Name Field Value
CLIA Number 05D0573825
LAB Type Physician Office
Facility Name ADVANCED DERMATOLOGY & LASER CENTER OF REDLANDS
Street 255 TERRACINA BLVD STE 206
City REDLANDS
State CA
ZIP 92373
Phone 909 792-8600
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 3/30/2023
Certificate Expiration Date 10/31/2025
Facility Type Physician Office
Lab Director FRED F. SOEPRONO MD

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