05D0580377 CLIA NUMBER - J ROBERT WEST MD INC DBA COAST DERMATOLOGY & LASER SURGERY CTR

Laboratory Demographics

  • CLIA Code: 05D0580377
  • Facility Name: J ROBERT WEST MD INC DBA COAST DERMATOLOGY & LASER SURGERY CTR
  • Facility Address: 31852 COAST HWY, STE 300
    LAGUNA BEACH, CA
    ZIP 92651
  • Facility Phone: 949 499-1389
  • Facility Type: Physician Office
  • Facility Type: Certificate of Compliance
  • Lab Director: GLENN I. GOLDBERG DO
  • NPI Number: 1760559116
  • Taxonomy: 207N00000X - Dermatology

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CLIA Record

Field Name Field Value
CLIA Number 05D0580377
LAB Type Physician Office
Facility Name J ROBERT WEST MD INC DBA COAST DERMATOLOGY & LASER SURGERY CTR
Street 31852 COAST HWY, STE 300
City LAGUNA BEACH
State CA
ZIP 92651
Phone 949 499-1389
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 9/27/2023
Certificate Expiration Date 10/31/2025
Facility Type Physician Office
Lab Director GLENN I. GOLDBERG DO

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