05D0987253 CLIA NUMBER - GREENFIELDS I ICF DDN

Laboratory Demographics

Map and Directions

Get Directions

CLIA Record

Field Name Field Value
CLIA Number 05D0987253
LAB Type Intermediate Care Facility for Mentally Retarded
Facility Name GREENFIELDS I ICF DDN
Street 219 TORREY PINES STREET
City VALLEJO
State CA
ZIP 94591
Phone 707 558-8149
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 5/31/2025
Certificate Expiration Date 5/30/2027
Facility Type Intermediate Care Facility for Mentally Retarded
Lab Director RODOLFO A. DAQUIOAG MD

Download Record

Download this CLIA record record in Text format: Export

Download this CLIA record record in Excel (CSV) format: Export

Download this CLIA record record in XML format: Export

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