36D1080426 CLIA NUMBER - KOUBA DERMATOLOGY LAB

Laboratory Demographics

  • CLIA Code: 36D1080426
  • Facility Name: KOUBA DERMATOLOGY LAB
  • Facility Address: 7301 SECOR RD
    LAMBERTVILLE, MI
    ZIP 48144
  • Facility Phone: 419 479-5791
  • Facility Type: Physician Office
  • Facility Type: Certificate of Compliance
  • Lab Director: DAVID J. KOUBA
  • NPI Number: 1326538703
  • Taxonomy: 207N00000X - Dermatology

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CLIA Record

Field Name Field Value
CLIA Number 36D1080426
LAB Type Physician Office
Facility Name KOUBA DERMATOLOGY LAB
Street 7301 SECOR RD
City LAMBERTVILLE
State MI
ZIP 48144
Phone 419 479-5791
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 3/26/2025
Certificate Expiration Date 3/25/2027
Facility Type Physician Office
Lab Director DAVID J. KOUBA

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