05D1060575 CLIA NUMBER - SOUTHERN CALIFORNIA SKIN & LASER

Laboratory Demographics

CLIA Number: 05D1060575

Facility Name: SOUTHERN CALIFORNIA SKIN & LASER

Facility Address:
27020 ALICIA PKWY STE G
LAGUNA NIGUEL, CA
ZIP 92677
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Facility Phone Number: 949 707-5734

Facility Type: Physician Office

Certificate Type: Certificate of Compliance

NPI Number: 1225227333

Taxonomy: 174400000X - Specialist
An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree.

CLIA Record

Field Name	Field Value
CLIA Number	05D1060575
LAB Type	Physician Office
Facility Name	SOUTHERN CALIFORNIA SKIN & LASER
Street	27020 ALICIA PKWY STE G
City	LAGUNA NIGUEL
State	CA
ZIP	92677
Phone	949 707-5734
CertificateType	2
CertificateEffectiveDate	5/17/2023
CertificateExpirationDate	5/16/2025
FacilityType	Compliance

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This page was last updated on: 4/23/2024