05D2186815 CLIA NUMBER - ARTIUS DERMATOLOGY ASSOCIATES, PC DBA LUX DERMATOLOGY

Laboratory Demographics

CLIA Number: 05D2186815

Facility Name: ARTIUS DERMATOLOGY ASSOCIATES, PC DBA LUX DERMATOLOGY

Facility Address:
5757 PACIFIC AVE STE 228
STOCKTON, CA
ZIP 95207
Get Directions

Facility Phone Number: 209 490-5050

Facility Type: Physician Office

Certificate Type: Waiver

NPI Number: 1982225496

Taxonomy: 332900000X - Non-Pharmacy Dispensing Site
A site other than a pharmacy that dispenses medicinal preparations under the supervision of a physician to patients for self-administration. (e.g. physician offices, ER, Urgent Care Centers, Rural Health Facilities, etc.)

CLIA Record

Field Name	Field Value
CLIA Number	05D2186815
LAB Type	Physician Office
Facility Name	ARTIUS DERMATOLOGY ASSOCIATES, PC DBA LUX DERMATOLOGY
Street	5757 PACIFIC AVE STE 228
City	STOCKTON
State	CA
ZIP	95207
Phone	209 490-5050
CertificateType	4
CertificateEffectiveDate	4/12/2023
CertificateExpirationDate	4/11/2025
FacilityType	Waiver

Download Record

Export to text format icon Download this CLIA NUMBER record in Text format: Export

Export to text format icon Download this CLIA NUMBER record in Excel (CSV) format: Export

Export to text format icon Download this CLIA NUMBER record in XML format: Export

This page was last updated on: 4/23/2024