MEDICARE: SALARI SKIN PATHOLOGY LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207ZD0900X	Dermatopathology (Pathology) Physician
2	291U00000X	Clinical Medical Laboratory

General Provider Information

NPI Number	:	1790574457
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SALARI SKIN PATHOLOGY LLC

Provider Business Mailing Address
First Line	:	3445 WASHINGTON DR STE 207
Second Line	:
City	:	EAGAN
State	:	MN
Zip	:	55122-4303
Country	:	US
Telephone Number	:	833-372-5274
Fax Number	:

Provider Business Practice Location Address
First Line	:	3445 WASHINGTON DR STE 207
Second Line	:
City	:	EAGAN
State	:	MN
Zip	:	55122-4303
Country	:	US
Telephone Number	:	833-372-5274
Fax Number	:

Authorized Official
Title or Position	:	CEO
Name	:	DR. BEHZAD SALARI
Credential	:	MD
Telephone Number	:	833-372-5274

Provider Enumeration Date	:	05/01/2025
Last Update Date	:	03/27/2026

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