05D1062915 CLIA NUMBER - MEDDERM ASSOCIATES, INC

Laboratory Demographics

  • CLIA Code: 05D1062915
  • Facility Name: MEDDERM ASSOCIATES, INC
  • Facility Address: 3965 5TH AVE, STE 200
    SAN DIEGO, CA
    ZIP 92103
  • Facility Phone: 619 542-0013
  • Facility Type: Physician Office
  • Facility Type: Certificate of Compliance
  • Lab Director: MICHELLE T. PELLE MD
  • NPI Number: 1063447936
  • Taxonomy: 207N00000X - Dermatology

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CLIA Record

Field Name Field Value
CLIA Number 05D1062915
LAB Type Physician Office
Facility Name MEDDERM ASSOCIATES, INC
Street 3965 5TH AVE, STE 200
City SAN DIEGO
State CA
ZIP 92103
Phone 619 542-0013
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 9/25/2023
Certificate Expiration Date 10/31/2025
Facility Type Physician Office
Lab Director MICHELLE T. PELLE MD

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