05D0598716 CLIA NUMBER - JEFFREY CARLSON MD

Laboratory Demographics

  • CLIA Code: 05D0598716
  • Facility Name: JEFFREY CARLSON MD
  • Facility Address: 2333 MOWRY AVE STE 220
    FREMONT, CA
    ZIP 94538
  • Facility Phone: 510 792-2012
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: CARL J. CARLSON
  • NPI Number: 1235109893
  • Taxonomy: 207N00000X - Dermatology

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CLIA Record

Field Name Field Value
CLIA Number 05D0598716
LAB Type Physician Office
Facility Name JEFFREY CARLSON MD
Street 2333 MOWRY AVE STE 220
City FREMONT
State CA
ZIP 94538
Phone 510 792-2012
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 8/4/2024
Certificate Expiration Date 8/3/2026
Facility Type Physician Office
Lab Director CARL J. CARLSON

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