05D0896423 CLIA NUMBER - JAY APPLEBAUM MD INC

Laboratory Demographics

CLIA Number: 05D0896423

Facility Name: JAY APPLEBAUM MD INC

Facility Address:
17601 E 17TH ST, STE 110
TUSTIN, CA
ZIP 92780
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Facility Phone Number: 714 790-0005

Facility Type: Physician Office

Certificate Type: Certificate of Compliance

NPI Number: 1740214618

Taxonomy: 207NS0135X - Dermatology
Procedural Dermatology, a subspecialty of Dermatology, encompassing a wide variety of surgical procedures and methods to remove or modify skin tissue for health or cosmetic benefit. These methods include scalpel surgery, laser surgery, chemical surgery, cryosurgery (liquid nitrogen), electrosurgery, aspiration surgery, liposuction, injection of filler substances, and Mohs micrographic controlled surgery (a special technique for the removal of growths, especially skin cancers).

CLIA Record

Field Name	Field Value
CLIA Number	05D0896423
LAB Type	Physician Office
Facility Name	JAY APPLEBAUM MD INC
Street	17601 E 17TH ST, STE 110
City	TUSTIN
State	CA
ZIP	92780
Phone	714 790-0005
CertificateType	2
CertificateEffectiveDate	8/21/2021
CertificateExpirationDate	4/30/2024
FacilityType	Compliance

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