05D2163005 CLIA NUMBER - LAGUNA DERMATOLOGY

Laboratory Demographics

  • CLIA Code: 05D2163005
  • Facility Name: LAGUNA DERMATOLOGY
  • Facility Address: 23521 PASEO DE VALENCIA STE 102
    LAGUNA HILLS, CA
    ZIP 92653
  • Facility Phone: 949 520-1815
  • Facility Type: Physician Office
  • Facility Type: Certificate of Compliance
  • Lab Director: JENNIFER CHANNUAL
  • NPI Number: 1689986374
  • Taxonomy: 207N00000X - Dermatology

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CLIA Record

Field Name Field Value
CLIA Number 05D2163005
LAB Type Physician Office
Facility Name LAGUNA DERMATOLOGY
Street 23521 PASEO DE VALENCIA STE 102
City LAGUNA HILLS
State CA
ZIP 92653
Phone 949 520-1815
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 1/14/2024
Certificate Expiration Date 1/13/2026
Facility Type Physician Office
Lab Director JENNIFER CHANNUAL

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