06D2099836 CLIA NUMBER - SKIN, PC DBA IDEAL DERMATOLOGY

Laboratory Demographics

  • CLIA Code: 06D2099836
  • Facility Name: SKIN, PC DBA IDEAL DERMATOLOGY
  • Facility Address: 905 ALPINE AVE
    BOULDER, CO
    ZIP 80304
  • Facility Phone: 970 667-3116
  • Facility Type: Physician Office
  • Facility Type: Certificate of Compliance
  • Lab Director: KEVIN J. MOTT
  • NPI Number: 1447629886
  • Taxonomy: 207ND0101X - Dermatology

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CLIA Record

Field Name Field Value
CLIA Number 06D2099836
LAB Type Physician Office
Facility Name SKIN, PC DBA IDEAL DERMATOLOGY
Street 905 ALPINE AVE
City BOULDER
State CO
ZIP 80304
Phone 970 667-3116
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 1/28/2024
Certificate Expiration Date 1/27/2026
Facility Type Physician Office
Lab Director KEVIN J. MOTT

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