05D2098658 CLIA NUMBER - LOMA LINDA DERMATOPATHOLOGY

Laboratory Demographics

  • CLIA Code: 05D2098658
  • Facility Name: LOMA LINDA DERMATOPATHOLOGY
  • Facility Address: 25084 BARTON RD STE B
    LOMA LINDA, CA
    ZIP 92354
  • Facility Phone: 909 796-2211
  • Facility Type: Independent
  • Facility Type: Certificate of Compliance
  • Lab Director: FRED F. SOEPRONO MD
  • NPI Number: 1235140336
  • Taxonomy: 213E00000X - Podiatrist

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CLIA Record

Field Name Field Value
CLIA Number 05D2098658
LAB Type Independent
Facility Name LOMA LINDA DERMATOPATHOLOGY
Street 25084 BARTON RD STE B
City LOMA LINDA
State CA
ZIP 92354
Phone 909 796-2211
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 2/5/2022
Certificate Expiration Date 10/31/2025
Facility Type Independent
Lab Director FRED F. SOEPRONO MD

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