05D1043905 CLIA NUMBER - PENINSULA EYE SURGERY CENTER

Laboratory Demographics

  • CLIA Code: 05D1043905
  • Facility Name: PENINSULA EYE SURGERY CENTER
  • Facility Address: 1128 W EL CAMINO REAL
    MOUNTAIN VIEW, CA
    ZIP 94040
  • Facility Phone: 650 964-3200
  • Facility Type: Ambulatory Surgery Center
  • Facility Type: Waiver
  • Lab Director: DAVID F. CHANG MD
  • NPI Number: 1770652216
  • Taxonomy: 261QS0132X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 05D1043905
LAB Type Ambulatory Surgery Center
Facility Name PENINSULA EYE SURGERY CENTER
Street 1128 W EL CAMINO REAL
City MOUNTAIN VIEW
State CA
ZIP 94040
Phone 650 964-3200
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 8/5/2025
Certificate Expiration Date 8/4/2027
Facility Type Ambulatory Surgery Center
Lab Director DAVID F. CHANG MD

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