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Recently Updated NPI Information — some details in this NPI profile have been updated in the NPI registry within the last 60 days.

CLEAR CHOICE DERMATOLOGY
NPI 1316797640
Pathology - Dermatopathology in Salem, OR

Active since March 27, 2024CLIA 38D2245554 · Certificate of Compliance
966 12TH ST SE STE 130, SALEM, OR 97302(541) 316-6575(541) 210-8913 Get Directions Write a Review

NPPES record last updated: October 15, 2026. Verified against the NPPES registry weekly; last sync: November 08, 2026.

About Clear Choice Dermatology NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

CLEAR CHOICE DERMATOLOGY (NPI 1316797640) is a healthcare organization registered as a dermatopathology in Salem, Oregon and active in the NPI registry since March 2024. The organization holds a CLIA Certificate of Compliance certificate valid through March 22, 2028 and lists Collin Matthew Blattner, Owner, as its authorized official.

NPPES Registry Identity

NPI1316797640
Entity TypeOrganization
Primary Taxonomy207ZD0900X
Legal Business NameCLEAR CHOICE DERMATOLOGY
Location Address966 12TH ST SE STE 130Salem, OR 97302-2860
Mailing AddressPo Box 2430The Dalles, OR 97058-8022 · (541) 316-6575 · Fax (541) 210-8913
Phone(541) 316-6575
Fax(541) 210-8913
Organization SubpartYes
Authorized OfficialCollin Matthew BlattnerOwner · (602) 228-1967
Enumeration DateMarch 27, 2024
Last NPPES UpdateOctober 15, 2026
NPPES CertifiedOctober 15, 2026
✔ NPI 1316797640 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPathology · DermatopathologyAllopathic & Osteopathic Physicians
Taxonomy Code207ZD0900X
Definition
A dermatopathologist is an expert in diagnosing and monitoring diseases of the skin including infectious, immunologic, degenerative, and neoplastic diseases. This entails the examination and interpretation of specially prepared tissue sections, cellular scrapings, and smears of skin lesions by means of light microscopy, electron microscopy, and fluorescence microscopy.
966 12TH ST SE STE 130, Salem, OR 97302
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Other Names 1

Other NameCc Dermpath Lab

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Compliance 38D2245554

Clear Choice Dermatology · Salem, OR
Active · expires Mar 22, 2028
CLIA Number38D2245554
Laboratory TypePhysician Office
Certificate Effective DateMarch 23, 2026
Certificate Expiration DateMarch 22, 2028
Laboratory DirectorCollin T. Blattner
Laboratory Phone(503) 837-6395
Laboratory LocationClear Choice Dermatology966 12th St SE Suite #130, Salem, OR 97302
CLIA data matches this NPI record on: Name
This certificate is issued to a laboratory after an inspection that finds the laboratory to be in compliance with all applicable CLIA requirements.

Other Providers at the Same Location NPPES 7

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

SHWETHA R GURRAM M.D
Family Medicine
966 12TH ST SE STE 130
SALEM, OR 97302
Marion County (503) 814-4400
JESSICA PETERSON RD
Nutritionist
966 12TH ST SE STE 130
SALEM, OR 97302
Marion County (503) 814-4400
JANE ELLEN BIRDSONG FNP-C
Family Medicine
966 12TH ST SE STE 130
SALEM, OR 97302
Marion County (503) 814-4400
SIDNEY THOMPSON PA-C
Physician Assistant
966 12TH ST SE STE 130
SALEM, OR 97302
Marion County (503) 837-6395
LUKE DANG
Pathology (Anatomic Pathology & Clinical Pathology)
966 12TH ST SE STE 130
SALEM, OR 97302
Marion County (503) 837-6395
RAE LYNN SIMMONS
Nurse Practitioner (Family)
966 12TH ST SE STE 130
SALEM, OR 97302
Marion County (503) 837-6395
MARTINA ANDREA SHANNON PA-C
Physician Assistant
966 12TH ST SE STE 130
SALEM, OR 97302
Marion County (503) 837-6395

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Clear Choice Dermatology's NPI number?

The NPI number for Clear Choice Dermatology is 1316797640. It was assigned to this organization in the NPPES registry on March 27, 2024. The provider is also known as CC Dermpath Lab.

Where is Clear Choice Dermatology located?

Clear Choice Dermatology is located at 966 12th St SE Ste 130, Salem, OR 97302. The listed phone number is (541) 316-6575.

What is Clear Choice Dermatology's specialty?

The primary specialty registered for this NPI is Pathology, specializing in Dermatopathology, with taxonomy code 207ZD0900X.

Does Clear Choice Dermatology hold a CLIA laboratory certificate?

Yes. A Certificate of Compliance (number 38D2245554) is associated with this NPI, valid through March 22, 2028. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Clear Choice Dermatology was last updated on October 15, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 28 days ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.