05D1021721 CLIA NUMBER - GREENBRAE SURGERY CENTER

Laboratory Demographics

  • CLIA Code: 05D1021721
  • Facility Name: GREENBRAE SURGERY CENTER
  • Facility Address: 575 SIR FRANCIS DRAKE BLVD SUITE 3
    GREENBRAE, CA
    ZIP 94904
  • Facility Phone: 415 925-8900
  • Facility Type: Ambulatory Surgery Center
  • Facility Type: Waiver
  • Lab Director: ROBERT G. AYCOCK MD
  • NPI Number: 1518133321
  • Taxonomy: 261QA1903X - Clinic/Center

Map and Directions

Get Directions

CLIA Record

Field Name Field Value
CLIA Number 05D1021721
LAB Type Ambulatory Surgery Center
Facility Name GREENBRAE SURGERY CENTER
Street 575 SIR FRANCIS DRAKE BLVD SUITE 3
City GREENBRAE
State CA
ZIP 94904
Phone 415 925-8900
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 1/30/2024
Certificate Expiration Date 1/29/2026
Facility Type Ambulatory Surgery Center
Lab Director ROBERT G. AYCOCK MD

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