05D0887060 CLIA NUMBER - MARIN OPHTHALMIC SURGERY CENTER

Laboratory Demographics

CLIA Number: 05D0887060

Facility Name: MARIN OPHTHALMIC SURGERY CENTER

Facility Address:
901 E STREET, STE 270
SAN RAFAEL, CA
ZIP 94901
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Facility Phone Number: 415 454-5565

Facility Type: Ambulatory Surgery Center

Certificate Type: Waiver

NPI Number: 1225016769

Taxonomy: 174400000X - Specialist
An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree.

CLIA Record

Field Name	Field Value
CLIA Number	05D0887060
LAB Type	Ambulatory Surgery Center
Facility Name	MARIN OPHTHALMIC SURGERY CENTER
Street	901 E STREET, STE 270
City	SAN RAFAEL
State	CA
ZIP	94901
Phone	415 454-5565
CertificateType	4
CertificateEffectiveDate	6/3/2022
CertificateExpirationDate	6/2/2024
FacilityType	Waiver

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This page was last updated on: 4/23/2024