05D2165310 CLIA NUMBER - PACIFIC DERMATOLOGY INSTITUTE

Laboratory Demographics

  • CLIA Code: 05D2165310
  • Facility Name: PACIFIC DERMATOLOGY INSTITUTE
  • Facility Address: 1481 FORD ST STE 102
    REDLANDS, CA
    ZIP 92373
  • Facility Phone: 909 748-5503
  • Facility Type: Physician Office
  • Facility Type: Certificate of Compliance
  • Lab Director: DR. THOMAS G. MUNYON
  • NPI Number: 1740410182
  • Taxonomy: 207N00000X - Dermatology

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CLIA Record

Field Name Field Value
CLIA Number 05D2165310
LAB Type Physician Office
Facility Name PACIFIC DERMATOLOGY INSTITUTE
Street 1481 FORD ST STE 102
City REDLANDS
State CA
ZIP 92373
Phone 909 748-5503
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 3/3/2022
Certificate Expiration Date 10/31/2025
Facility Type Physician Office
Lab Director DR. THOMAS G. MUNYON

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