16D2115309 CLIA NUMBER - LAKES DERMATOLOGY, PLLC

Laboratory Demographics

  • CLIA Code: 16D2115309
  • Facility Name: LAKES DERMATOLOGY, PLLC
  • Facility Address: 2704 ENTERPRISE AVE
    SPIRIT LAKE, IA
    ZIP 51360
  • Facility Phone: 712 336-2728
  • Facility Type: Practitioner Other
  • Facility Type: Waiver
  • Lab Director: CRYSTAL MEYER
  • NPI Number: 1194186833
  • Taxonomy: 363L00000X - Nurse Practitioner

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CLIA Record

Field Name Field Value
CLIA Number 16D2115309
LAB Type Practitioner Other
Facility Name LAKES DERMATOLOGY, PLLC
Street 2704 ENTERPRISE AVE
City SPIRIT LAKE
State IA
ZIP 51360
Phone 712 336-2728
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 3/29/2024
Certificate Expiration Date 3/28/2026
Facility Type Practitioner Other
Lab Director CRYSTAL MEYER

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