05D1038281 CLIA NUMBER - SUTTER BAY MEDICAL FOUNDATION DBA SURGERY CENTER SAN JOSE

Laboratory Demographics

  • CLIA Code: 05D1038281
  • Facility Name: SUTTER BAY MEDICAL FOUNDATION DBA SURGERY CENTER SAN JOSE
  • Facility Address: 2581 SAMARITAN DR STE 308
    SAN JOSE, CA
    ZIP 95124
  • Facility Phone: 408 355-1700
  • Facility Type: Ambulatory Surgery Center
  • Facility Type: Microscopy
  • Lab Director: JENNIFER BASARAB-TUNG
  • NPI Number: 1043654486
  • Taxonomy: 261QA1903X - Clinic/Center

Map and Directions

Get Directions

CLIA Record

Field Name Field Value
CLIA Number 05D1038281
LAB Type Ambulatory Surgery Center
Facility Name SUTTER BAY MEDICAL FOUNDATION DBA SURGERY CENTER SAN JOSE
Street 2581 SAMARITAN DR STE 308
City SAN JOSE
State CA
ZIP 95124
Phone 408 355-1700
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 3/17/2025
Certificate Expiration Date 3/16/2027
Facility Type Ambulatory Surgery Center
Lab Director JENNIFER BASARAB-TUNG

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