05D0997323 CLIA NUMBER - JEFFREY G MACE MD PROF CORP

Laboratory Demographics

  • CLIA Code: 05D0997323
  • Facility Name: JEFFREY G MACE MD PROF CORP
  • Facility Address: 242 GREEN VALLEY RD
    FREEDOM, CA
    ZIP 95019
  • Facility Phone: 831 724-1811
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: JEFFREY G. MACE MD
  • NPI Number: 1861484511
  • Taxonomy: 207RC0000X - Internal Medicine

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CLIA Record

Field Name Field Value
CLIA Number 05D0997323
LAB Type Physician Office
Facility Name JEFFREY G MACE MD PROF CORP
Street 242 GREEN VALLEY RD
City FREEDOM
State CA
ZIP 95019
Phone 831 724-1811
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 3/12/2024
Certificate Expiration Date 3/11/2026
Facility Type Physician Office
Lab Director JEFFREY G. MACE MD

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