05D1001531 CLIA NUMBER - COSMETIC DERMATOLOGY CENTER

Laboratory Demographics

  • CLIA Code: 05D1001531
  • Facility Name: COSMETIC DERMATOLOGY CENTER
  • Facility Address: 1535 EUREKA RD
    ROSEVILLE, CA
    ZIP 95661
  • Facility Phone: 916 773-3376
  • Facility Type: Physician Office
  • Facility Type: Microscopy
  • Lab Director: SCOTT B. HEARTH
  • NPI Number: 1871908277
  • Taxonomy: 174400000X - Specialist

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CLIA Record

Field Name Field Value
CLIA Number 05D1001531
LAB Type Physician Office
Facility Name COSMETIC DERMATOLOGY CENTER
Street 1535 EUREKA RD
City ROSEVILLE
State CA
ZIP 95661
Phone 916 773-3376
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 7/12/2024
Certificate Expiration Date 7/11/2026
Facility Type Physician Office
Lab Director SCOTT B. HEARTH

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