05D0713339 CLIA NUMBER - RANDY JACOBS DERMATOLOGY INC

Laboratory Demographics

  • CLIA Code: 05D0713339
  • Facility Name: RANDY JACOBS DERMATOLOGY INC
  • Facility Address: 28120 BRADLEY RD
    MENIFEE, CA
    ZIP 92586
  • Facility Phone: 951 672-7673
  • Facility Type: Physician Office
  • Facility Type: Certificate of Compliance
  • Lab Director: RANDOLPH J. JACOBS MD
  • NPI Number: 1699872630
  • Taxonomy: 207N00000X - Dermatology

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CLIA Record

Field Name Field Value
CLIA Number 05D0713339
LAB Type Physician Office
Facility Name RANDY JACOBS DERMATOLOGY INC
Street 28120 BRADLEY RD
City MENIFEE
State CA
ZIP 92586
Phone 951 672-7673
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 10/10/2021
Certificate Expiration Date 10/31/2025
Facility Type Physician Office
Lab Director RANDOLPH J. JACOBS MD

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