05D2130455 CLIA NUMBER - LACA DERMATOLOGY INC

Laboratory Demographics

  • CLIA Code: 05D2130455
  • Facility Name: LACA DERMATOLOGY INC
  • Facility Address: 4955 VAN NUYS BLVD, STE 516
    SHERMAN OAKS, CA
    ZIP 91403
  • Facility Phone: 818 789-6296
  • Facility Type: Physician Office
  • Facility Type: Certificate of Compliance
  • Lab Director: ANNE C. HARDICK DACKO
  • NPI Number: 1811497928
  • Taxonomy: 207ND0101X - Dermatology

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CLIA Record

Field Name Field Value
CLIA Number 05D2130455
LAB Type Physician Office
Facility Name LACA DERMATOLOGY INC
Street 4955 VAN NUYS BLVD, STE 516
City SHERMAN OAKS
State CA
ZIP 91403
Phone 818 789-6296
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 3/13/2024
Certificate Expiration Date 3/12/2026
Facility Type Physician Office
Lab Director ANNE C. HARDICK DACKO

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