05D0691462 CLIA NUMBER - GOLDEN STATE DERMATOLOGY ASSOCIATES INC

Laboratory Demographics

  • CLIA Code: 05D0691462
  • Facility Name: GOLDEN STATE DERMATOLOGY ASSOCIATES INC
  • Facility Address: 2255 YGNACIO VALLEY RD STE B1
    WALNUT CREEK, CA
    ZIP 94598
  • Facility Phone: 925 945-7005
  • Facility Type: Physician Office
  • Facility Type: Microscopy
  • Lab Director: JAY ZIMMERMAN
  • NPI Number: 1407285240
  • Taxonomy: 207N00000X - Dermatology

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CLIA Record

Field Name Field Value
CLIA Number 05D0691462
LAB Type Physician Office
Facility Name GOLDEN STATE DERMATOLOGY ASSOCIATES INC
Street 2255 YGNACIO VALLEY RD STE B1
City WALNUT CREEK
State CA
ZIP 94598
Phone 925 945-7005
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 11/7/2024
Certificate Expiration Date 11/6/2026
Facility Type Physician Office
Lab Director JAY ZIMMERMAN

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