05D2288575 CLIA NUMBER - NORTHRIDGE CLINICAL TRIALS - CALIFORNIA DERMATOLOGY INSTITUTE

Laboratory Demographics

  • CLIA Code: 05D2288575
  • Facility Name: NORTHRIDGE CLINICAL TRIALS - CALIFORNIA DERMATOLOGY INSTITUTE
  • Facility Address: 18433 ROSCOE BLVD SUITE 104
    NORTHRIDGE, CA
    ZIP 91325
  • Facility Phone: 520 241-9453
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: NAVID EZRA
  • NPI Number: 1285642033
  • Taxonomy: 207Q00000X - Family Medicine

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CLIA Record

Field Name Field Value
CLIA Number 05D2288575
LAB Type Physician Office
Facility Name NORTHRIDGE CLINICAL TRIALS - CALIFORNIA DERMATOLOGY INSTITUTE
Street 18433 ROSCOE BLVD SUITE 104
City NORTHRIDGE
State CA
ZIP 91325
Phone 520 241-9453
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 8/28/2025
Certificate Expiration Date 8/27/2027
Facility Type Physician Office
Lab Director NAVID EZRA

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