05D0570186 CLIA NUMBER - GARY L MATSON DO

Laboratory Demographics

  • CLIA Code: 05D0570186
  • Facility Name: GARY L MATSON DO
  • Facility Address: 4501 MISSION BAY DR SUITE 3E
    SAN DIEGO, CA
    ZIP 92109
  • Facility Phone: 619 276-8223
  • Facility Type: Physician Office
  • Facility Type: Microscopy
  • Lab Director: CLIFFORD J. WARD MD
  • NPI Number: 1225357833
  • Taxonomy: 207Q00000X - Family Medicine

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CLIA Record

Field Name Field Value
CLIA Number 05D0570186
LAB Type Physician Office
Facility Name GARY L MATSON DO
Street 4501 MISSION BAY DR SUITE 3E
City SAN DIEGO
State CA
ZIP 92109
Phone 619 276-8223
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 9/1/2024
Certificate Expiration Date 8/31/2026
Facility Type Physician Office
Lab Director CLIFFORD J. WARD MD

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