05D0986243 CLIA NUMBER - PENINSULA DERMATOLOGIC SURGERY INC

Laboratory Demographics

  • CLIA Code: 05D0986243
  • Facility Name: PENINSULA DERMATOLOGIC SURGERY INC
  • Facility Address: 321 MIDDLEFIELD RD STE 245
    MENLO PARK, CA
    ZIP 94025
  • Facility Phone: 650 326-7222
  • Facility Type: Physician Office
  • Facility Type: Certificate of Compliance
  • Lab Director: JON C. STARR MD
  • NPI Number: 1598901340
  • Taxonomy: 207ND0101X - Dermatology

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CLIA Record

Field Name Field Value
CLIA Number 05D0986243
LAB Type Physician Office
Facility Name PENINSULA DERMATOLOGIC SURGERY INC
Street 321 MIDDLEFIELD RD STE 245
City MENLO PARK
State CA
ZIP 94025
Phone 650 326-7222
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 5/29/2022
Certificate Expiration Date 10/31/2025
Facility Type Physician Office
Lab Director JON C. STARR MD

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