05D1042496 CLIA NUMBER - ELISSA GROPEN DERMATOLOGY, INC

Laboratory Demographics

  • CLIA Code: 05D1042496
  • Facility Name: ELISSA GROPEN DERMATOLOGY, INC
  • Facility Address: 3576 ARLINGTON AVE, STE 102
    RIVERSIDE, CA
    ZIP 92506
  • Facility Phone: 951 684-8397
  • Facility Type: Physician Office
  • Facility Type: Microscopy
  • Lab Director: ELISSA GROPEN MD
  • NPI Number: 1700949112
  • Taxonomy: 174400000X - Specialist

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CLIA Record

Field Name Field Value
CLIA Number 05D1042496
LAB Type Physician Office
Facility Name ELISSA GROPEN DERMATOLOGY, INC
Street 3576 ARLINGTON AVE, STE 102
City RIVERSIDE
State CA
ZIP 92506
Phone 951 684-8397
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 1/1/2024
Certificate Expiration Date 12/31/2025
Facility Type Physician Office
Lab Director ELISSA GROPEN MD

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