05D2089223 CLIA NUMBER - BLUE HARBOR DERMATOLOGY INC

Laboratory Demographics

  • CLIA Code: 05D2089223
  • Facility Name: BLUE HARBOR DERMATOLOGY INC
  • Facility Address: 1501 SUPERIOR AVE STE 115
    NEWPORT BEACH, CA
    ZIP 92663
  • Facility Phone: 949 640-7546
  • Facility Type: Physician Office
  • Facility Type: Certificate of Compliance
  • Lab Director: KEVIN T. BELASCO
  • NPI Number: 1962829457
  • Taxonomy: 207N00000X - Dermatology

Map and Directions

Get Directions

CLIA Record

Field Name Field Value
CLIA Number 05D2089223
LAB Type Physician Office
Facility Name BLUE HARBOR DERMATOLOGY INC
Street 1501 SUPERIOR AVE STE 115
City NEWPORT BEACH
State CA
ZIP 92663
Phone 949 640-7546
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 7/19/2023
Certificate Expiration Date 10/31/2025
Facility Type Physician Office
Lab Director KEVIN T. BELASCO

Download Record

Download this CLIA record record in Text format: Export

Download this CLIA record record in Excel (CSV) format: Export

Download this CLIA record record in XML format: Export

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