05D2070588 CLIA NUMBER - DAVID E GOODMAN, MD, MSE, A PROFESSIONAL MEDICAL CORPORATION

Laboratory Demographics

  • CLIA Code: 05D2070588
  • Facility Name: DAVID E GOODMAN, MD, MSE, A PROFESSIONAL MEDICAL CORPORATION
  • Facility Address: 300 PROFESSIONAL CENTER DR, STE 326
    NOVATO, CA
    ZIP 94947
  • Facility Phone: 415 897-5400
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: DAVID E. GOODMAN
  • NPI Number: 1265588511
  • Taxonomy: 208D00000X - General Practice

Map and Directions

Get Directions

CLIA Record

Field Name Field Value
CLIA Number 05D2070588
LAB Type Physician Office
Facility Name DAVID E GOODMAN, MD, MSE, A PROFESSIONAL MEDICAL CORPORATION
Street 300 PROFESSIONAL CENTER DR, STE 326
City NOVATO
State CA
ZIP 94947
Phone 415 897-5400
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 12/19/2023
Certificate Expiration Date 12/18/2025
Facility Type Physician Office
Lab Director DAVID E. GOODMAN

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