05D1013047 CLIA NUMBER - DERMATOLOGIST MEDICAL GROUP OF NORTH COUNTY INC

Laboratory Demographics

  • CLIA Code: 05D1013047
  • Facility Name: DERMATOLOGIST MEDICAL GROUP OF NORTH COUNTY INC
  • Facility Address: 11943 EL CAMINO REAL, STE 220
    SAN DIEGO, CA
    ZIP 92130
  • Facility Phone: 760 758-5340
  • Facility Type: Physician Office
  • Facility Type: Certificate of Compliance
  • Lab Director: MICHELLE L. JACKSON
  • NPI Number: 1497399141
  • Taxonomy: 207N00000X - Dermatology

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CLIA Record

Field Name Field Value
CLIA Number 05D1013047
LAB Type Physician Office
Facility Name DERMATOLOGIST MEDICAL GROUP OF NORTH COUNTY INC
Street 11943 EL CAMINO REAL, STE 220
City SAN DIEGO
State CA
ZIP 92130
Phone 760 758-5340
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 11/5/2023
Certificate Expiration Date 11/4/2025
Facility Type Physician Office
Lab Director MICHELLE L. JACKSON

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