05D2164178 CLIA NUMBER - CSI MEDICAL GROUP

Laboratory Demographics

  • CLIA Code: 05D2164178
  • Facility Name: CSI MEDICAL GROUP
  • Facility Address: 3311 MISSION DRIVE
    SANTA CRUZ, CA
    ZIP 95065
  • Facility Phone: 831 475-4315
  • Facility Type: Physician Office
  • Facility Type: Certificate of Compliance
  • Lab Director: FRANK NOODLEMAN
  • NPI Number: 1871909804
  • Taxonomy: 207ND0101X - Dermatology

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CLIA Record

Field Name Field Value
CLIA Number 05D2164178
LAB Type Physician Office
Facility Name CSI MEDICAL GROUP
Street 3311 MISSION DRIVE
City SANTA CRUZ
State CA
ZIP 95065
Phone 831 475-4315
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 4/24/2024
Certificate Expiration Date 4/23/2026
Facility Type Physician Office
Lab Director FRANK NOODLEMAN

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