05D1048079 CLIA NUMBER - MARK L HOFF, MD MEDICAL PRACTICE

Laboratory Demographics

  • CLIA Code: 05D1048079
  • Facility Name: MARK L HOFF, MD MEDICAL PRACTICE
  • Facility Address: 999 S FAIRMONT AVE STE 135
    LODI, CA
    ZIP 95240
  • Facility Phone: 209 366-2031
  • Facility Type: Physician Office
  • Facility Type: Microscopy
  • Lab Director: MARK L. HOFF
  • NPI Number: 1558455618
  • Taxonomy: 207Q00000X - Family Medicine

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CLIA Record

Field Name Field Value
CLIA Number 05D1048079
LAB Type Physician Office
Facility Name MARK L HOFF, MD MEDICAL PRACTICE
Street 999 S FAIRMONT AVE STE 135
City LODI
State CA
ZIP 95240
Phone 209 366-2031
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 11/21/2023
Certificate Expiration Date 11/20/2025
Facility Type Physician Office
Lab Director MARK L. HOFF

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