29D0540265 CLIA NUMBER - CARSON DERMATOLOGY

Laboratory Demographics

  • CLIA Code: 29D0540265
  • Facility Name: CARSON DERMATOLOGY
  • Facility Address: 1505 MEDICAL PKWY
    CARSON CITY, NV
    ZIP 89703
  • Facility Phone: (775) 883-7811
  • Facility Type: Physician Office
  • Facility Type: Certificate of Compliance
  • Lab Director: ALAN DAVID TACK
  • NPI Number: 1780852368
  • Taxonomy: 207N00000X - Dermatology

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CLIA Record

Field Name Field Value
CLIA Number 29D0540265
LAB Type Physician Office
Facility Name CARSON DERMATOLOGY
Street 1505 MEDICAL PKWY
City CARSON CITY
State NV
ZIP 89703
Phone 7758837811
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 1/24/2025
Certificate Expiration Date 1/23/2027
Facility Type Physician Office
Lab Director ALAN DAVID TACK

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