24D2105418 CLIA NUMBER - LAKES DERMATOLOGY

Laboratory Demographics

  • CLIA Code: 24D2105418
  • Facility Name: LAKES DERMATOLOGY
  • Facility Address: 14305 SOUTHCROSS DR W #110
    BURNSVILLE, MN
    ZIP 55306
  • Facility Phone: (651) 340-1064
  • Facility Type: Physician Office
  • Facility Type: Certificate of Compliance
  • Lab Director: REHANA L. AHMED-SAUCEDO
  • NPI Number: 1962871608
  • Taxonomy: 207N00000X - Dermatology

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CLIA Record

Field Name Field Value
CLIA Number 24D2105418
LAB Type Physician Office
Facility Name LAKES DERMATOLOGY
Street 14305 SOUTHCROSS DR W #110
City BURNSVILLE
State MN
ZIP 55306
Phone 6513401064
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 7/20/2024
Certificate Expiration Date 7/19/2026
Facility Type Physician Office
Lab Director REHANA L. AHMED-SAUCEDO

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This page was last updated on: 5/18/2026