24D2302735 CLIA NUMBER - DERMATOLOGY PROFESSIONALS

Laboratory Demographics

  • CLIA Code: 24D2302735
  • Facility Name: DERMATOLOGY PROFESSIONALS
  • Facility Address: 1511 NORTHWAY DRIVE SUITE 103
    SAINT CLOUD, MN
    ZIP 56303
  • Facility Phone: 218 454-7546
  • Facility Type: Physician Office
  • Facility Type: Microscopy
  • Lab Director: DR. PAUL LUNDSTROM
  • NPI Number: 1467169979
  • Taxonomy: 207ND0101X - Dermatology

Map and Directions

Get Directions

CLIA Record

Field Name Field Value
CLIA Number 24D2302735
LAB Type Physician Office
Facility Name DERMATOLOGY PROFESSIONALS
Street 1511 NORTHWAY DRIVE SUITE 103
City SAINT CLOUD
State MN
ZIP 56303
Phone 218 454-7546
Certificate Type Certificate for Provider-Performed Microscopy Procedures (PPMP)
Certificate Type Description This certificate is issued to a laboratory in which a physician, midlevel practitioner or dentist performs no tests other than the microscopy procedures. This certificate permits the laboratory to also perform waived tests.
Certificate Effective Date 6/1/2024
Certificate Expiration Date 5/31/2026
Facility Type Physician Office
Lab Director DR. PAUL LUNDSTROM

Download Record

Download this CLIA record record in Text format: Export

Download this CLIA record record in Excel (CSV) format: Export

Download this CLIA record record in XML format: Export

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