05D2106611 CLIA NUMBER - NEWPORT DERMATOLOGY INSTITUTE

Laboratory Demographics

  • CLIA Code: 05D2106611
  • Facility Name: NEWPORT DERMATOLOGY INSTITUTE
  • Facility Address: 2121 E COAST HWY STE 110
    CORONA DEL MAR, CA
    ZIP 92625
  • Facility Phone: 949 629-4263
  • Facility Type: Physician Office
  • Facility Type: Certificate of Compliance
  • Lab Director: MARK M. TRAN
  • NPI Number: 1679971535
  • Taxonomy: 207N00000X - Dermatology

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CLIA Record

Field Name Field Value
CLIA Number 05D2106611
LAB Type Physician Office
Facility Name NEWPORT DERMATOLOGY INSTITUTE
Street 2121 E COAST HWY STE 110
City CORONA DEL MAR
State CA
ZIP 92625
Phone 949 629-4263
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 8/25/2022
Certificate Expiration Date 10/31/2025
Facility Type Physician Office
Lab Director MARK M. TRAN

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