CLIA lab
CLIA 05D2216008: Mact Dental, Jackson
Jackson, CA. Certificate and address details from the CMS Provider of Services file for clinical laboratories.
CLIA number 05D2216008 belongs to Mact Dental, Jackson in Jackson, CA.
Certificate of Waiver, effective March 9, 2025, expires March 8, 2027.
Active in the CMS Provider of Services file posted October 16, 2026.
Source: CMS Provider of Services File, Clinical Laboratories (CLIA), as of October 16, 2026. Publisher page
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Certificate
- Certificate type
- Certificate of Waiver
- Certificate effective
- March 9, 2025
- Certificate expiration
- March 8, 2027
- Status in the CMS file
- Active (termination code 00)
- Original participation date
- March 9, 2021
- Facility type
- Ancillary test site
- Ownership (control type)
- Government, other
- Lab classification
- CLIA laboratory
Source: CMS Provider of Services File, Clinical Laboratories (CLIA), as of October 16, 2026. Publisher page
Lab and contact
- CLIA number
- 05D2216008
- Lab name
- Mact Dental, Jackson
- Address
- 12150 New York Ranch Road, Jackson, CA 95642
- Phone
- (209) 754-6262
- Fax
- (209) 754-6275
Annual test volume the lab reported
- Waived tests
- 50
Volumes are what the lab reported to CMS on its CMS-116 application, as carried in the file.
Other labs in Jackson, CA
- Amador Family Physicians Medical CorporationCertificate for Provider-Performed Microscopy Procedures, Physician office05D0984183
- Hospice of Amador & CalaverasCertificate of Waiver, Hospice05D0926617
- Irc-Sutter Health Jackson, LLCCertificate of Waiver, End stage renal disease dialysis facility05D2302474
- Jackson Rancheria Medical CenterCertificate of Waiver, Physician office05D2074377
- Kit Carson Nursing and RehabilitationCertificate of Waiver, Skilled nursing or nursing facility05D0725688
- Mact Medical, JacksonCertificate for Provider-Performed Microscopy Procedures, Other05D0698999
- Safeway Pharmacy #2778Certificate of Waiver, Pharmacy05D2079747
- Sierra Eyecare AssociatesCertificate of Waiver, Other practitioner05D2173099
- Sutter Amador Surgery Center, LLCCertificate of Waiver, Ambulatory surgery center05D1036653
- Sutter-Amador Hospital LaboratoryCertificate of Accreditation, Hospital05D0063882
Related
Questions
What is the CLIA number for Mact Dental, Jackson in Jackson?
05D2216008, per the CMS Provider of Services file posted October 16, 2026.
What CLIA certificate does Mact Dental, Jackson hold?
A Certificate of Waiver, according to the CMS file.
When does CLIA 05D2216008 expire?
The CMS file lists March 8, 2027 as the certificate expiration date; the certificate took effect March 9, 2025.