05D2317827 CLIA NUMBER - PACIFIC SKIN INSTITUTE

Laboratory Demographics

  • CLIA Code: 05D2317827
  • Facility Name: PACIFIC SKIN INSTITUTE
  • Facility Address: 1010 NUT TREE RD STE 150
    VACAVILLE, CA
    ZIP 95687
  • Facility Phone: 916 925-7020
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: AN YEN
  • NPI Number: 1184027104
  • Taxonomy: 207NS0135X - Dermatology

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CLIA Record

Field Name Field Value
CLIA Number 05D2317827
LAB Type Physician Office
Facility Name PACIFIC SKIN INSTITUTE
Street 1010 NUT TREE RD STE 150
City VACAVILLE
State CA
ZIP 95687
Phone 916 925-7020
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 1/31/2025
Certificate Expiration Date 1/30/2027
Facility Type Physician Office
Lab Director AN YEN

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