05D1013059 CLIA NUMBER - DERMATOLOGIST MEDICAL GROUP OF NORTH COUNTY INC

Laboratory Demographics

  • CLIA Code: 05D1013059
  • Facility Name: DERMATOLOGIST MEDICAL GROUP OF NORTH COUNTY INC
  • Facility Address: 1200 GARDEN VIEW RD, STE 108
    ENCINITAS, CA
    ZIP 92024
  • Facility Phone: 760 758-5340
  • Facility Type: Physician Office
  • Facility Type: Certificate of Compliance
  • Lab Director: MICHELLE JACKSON MD
  • NPI Number: 1538191077
  • Taxonomy: 207N00000X - Dermatology

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CLIA Record

Field Name Field Value
CLIA Number 05D1013059
LAB Type Physician Office
Facility Name DERMATOLOGIST MEDICAL GROUP OF NORTH COUNTY INC
Street 1200 GARDEN VIEW RD, STE 108
City ENCINITAS
State CA
ZIP 92024
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 JACKSON MD

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