05D0699022 CLIA NUMBER - MACT MEDICAL MARIPOSA

Laboratory Demographics

  • CLIA Code: 05D0699022
  • Facility Name: MACT MEDICAL MARIPOSA
  • Facility Address: 5192 HOSPITAL ROAD
    MARIPOSA, CA
    ZIP 95338
  • Facility Phone: 209 742-6144
  • Facility Type: Other
  • Facility Type: Microscopy
  • Lab Director: ROBERT I. REINA, MD
  • NPI Number: 1740272731
  • Taxonomy: 261Q00000X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 05D0699022
LAB Type Other
Facility Name MACT MEDICAL MARIPOSA
Street 5192 HOSPITAL ROAD
City MARIPOSA
State CA
ZIP 95338
Phone 209 742-6144
Certificate Type Certificate for Provider-Performed Microscopy Procedures (PPMP)
Certificate Type Description This certificate is issued to a laboratory in which a physician, midlevel practitioner or dentist performs no tests other than the microscopy procedures. This certificate permits the laboratory to also perform waived tests.
Certificate Effective Date 9/1/2024
Certificate Expiration Date 8/31/2026
Facility Type Other
Lab Director ROBERT I. REINA, MD

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This page was last updated on: 3/20/2025