05D2185251 CLIA NUMBER - PALO ALTO MEDICAL FOUNDATION SAN CARLOS DERMATOLOGY MOHS

Laboratory Demographics

  • CLIA Code: 05D2185251
  • Facility Name: PALO ALTO MEDICAL FOUNDATION SAN CARLOS DERMATOLOGY MOHS
  • Facility Address: 301 INDUSTRIAL RD, 3RD FL
    SAN CARLOS, CA
    ZIP 94070
  • Facility Phone: 650 596-4160
  • Facility Type: Physician Office
  • Facility Type: Certificate of Compliance
  • Lab Director: SUSAN T. BUTLER
  • NPI Number: 1306560842
  • Taxonomy: 291U00000X - Clinical Medical Laboratory

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CLIA Record

Field Name Field Value
CLIA Number 05D2185251
LAB Type Physician Office
Facility Name PALO ALTO MEDICAL FOUNDATION SAN CARLOS DERMATOLOGY MOHS
Street 301 INDUSTRIAL RD, 3RD FL
City SAN CARLOS
State CA
ZIP 94070
Phone 650 596-4160
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 5/10/2022
Certificate Expiration Date 10/31/2025
Facility Type Physician Office
Lab Director SUSAN T. BUTLER

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