05D2255566 CLIA NUMBER - STEPHANIE J MARTIN, INC DBA CAL COAST DERMATOLOGY

Laboratory Demographics

  • CLIA Code: 05D2255566
  • Facility Name: STEPHANIE J MARTIN, INC DBA CAL COAST DERMATOLOGY
  • Facility Address: 16550 VENTURA BLVD SUITE 120
    ENCINO, CA
    ZIP 91436
  • Facility Phone: 818 208-9204
  • Facility Type: Physician Office
  • Facility Type: Certificate of Compliance
  • Lab Director: STEPHANIE J. MARTIN
  • NPI Number: 1962075754
  • Taxonomy: 207N00000X - Dermatology

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CLIA Record

Field Name Field Value
CLIA Number 05D2255566
LAB Type Physician Office
Facility Name STEPHANIE J MARTIN, INC DBA CAL COAST DERMATOLOGY
Street 16550 VENTURA BLVD SUITE 120
City ENCINO
State CA
ZIP 91436
Phone 818 208-9204
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 9/14/2023
Certificate Expiration Date 10/31/2025
Facility Type Physician Office
Lab Director STEPHANIE J. MARTIN

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