05D0685796 CLIA NUMBER - CORONADO DERMATOLOGY

Laboratory Demographics

  • CLIA Code: 05D0685796
  • Facility Name: CORONADO DERMATOLOGY
  • Facility Address: 230 PROSPECT PL STE 260
    CORONADO, CA
    ZIP 92118
  • Facility Phone: 619 437-1146
  • Facility Type: Physician Office
  • Facility Type: Certificate of Compliance
  • Lab Director: CHARLENE KAKIMOTO MD
  • NPI Number: 1215087739
  • Taxonomy: 251300000X - Local Education Agency (LEA)

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CLIA Record

Field Name Field Value
CLIA Number 05D0685796
LAB Type Physician Office
Facility Name CORONADO DERMATOLOGY
Street 230 PROSPECT PL STE 260
City CORONADO
State CA
ZIP 92118
Phone 619 437-1146
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 12/8/2022
Certificate Expiration Date 10/31/2025
Facility Type Physician Office
Lab Director CHARLENE KAKIMOTO MD

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