24D2104679 CLIA NUMBER - INTEGRA DERMATOLOGY, PA

Laboratory Demographics

  • CLIA Code: 24D2104679
  • Facility Name: INTEGRA DERMATOLOGY, PA
  • Facility Address: 5725 LOFTUS LANE
    SAVAGE, MN
    ZIP 55378
  • Facility Phone: 612 767-6000
  • Facility Type: Physician Office
  • Facility Type: Certificate of Compliance
  • Lab Director: MIMI LAM
  • NPI Number: 1366820136
  • Taxonomy: 207N00000X - Dermatology

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CLIA Record

Field Name Field Value
CLIA Number 24D2104679
LAB Type Physician Office
Facility Name INTEGRA DERMATOLOGY, PA
Street 5725 LOFTUS LANE
City SAVAGE
State MN
ZIP 55378
Phone 612 767-6000
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 7/26/2024
Certificate Expiration Date 7/25/2026
Facility Type Physician Office
Lab Director MIMI LAM

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