05D2155665 CLIA NUMBER - DERMATOLOGY SPECIALIST, INC

Laboratory Demographics

  • CLIA Code: 05D2155665
  • Facility Name: DERMATOLOGY SPECIALIST, INC
  • Facility Address: 31515 RANCHO PUEBLO ROAD SUITE #102
    TEMECULA, CA
    ZIP 92592
  • Facility Phone: 951 225-7873
  • Facility Type: Physician Office
  • Facility Type: Microscopy
  • Lab Director: ARUN VENKAT
  • NPI Number: 1053778274
  • Taxonomy: 363A00000X - Physician Assistant

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CLIA Record

Field Name Field Value
CLIA Number 05D2155665
LAB Type Physician Office
Facility Name DERMATOLOGY SPECIALIST, INC
Street 31515 RANCHO PUEBLO ROAD SUITE #102
City TEMECULA
State CA
ZIP 92592
Phone 951 225-7873
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 10/2/2024
Certificate Expiration Date 10/1/2026
Facility Type Physician Office
Lab Director ARUN VENKAT

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