05D2154126 CLIA NUMBER - WEST OAK DERMATOLOGY

Laboratory Demographics

  • CLIA Code: 05D2154126
  • Facility Name: WEST OAK DERMATOLOGY
  • Facility Address: 258 GIBSON DR, STE 140
    ROSEVILLE, CA
    ZIP 95678
  • Facility Phone: 916 755-0077
  • Facility Type: Physician Office
  • Facility Type: Microscopy
  • Lab Director: KATHRYN GANT
  • NPI Number: 1003327545
  • Taxonomy: 207N00000X - Dermatology

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CLIA Record

Field Name Field Value
CLIA Number 05D2154126
LAB Type Physician Office
Facility Name WEST OAK DERMATOLOGY
Street 258 GIBSON DR, STE 140
City ROSEVILLE
State CA
ZIP 95678
Phone 916 755-0077
Certificate Type Certificate for Provider-Performed Microscopy Procedures (PPMP)
Certificate Type Description This certificate is issued to a laboratory in which a physician, midlevel practitioner or dentist performs no tests other than the microscopy procedures. This certificate permits the laboratory to also perform waived tests.
Certificate Effective Date 9/6/2024
Certificate Expiration Date 9/5/2026
Facility Type Physician Office
Lab Director KATHRYN GANT

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