05D1090125 CLIA NUMBER - SAN MATEO SURGERY CENTER

Laboratory Demographics

  • CLIA Code: 05D1090125
  • Facility Name: SAN MATEO SURGERY CENTER
  • Facility Address: 66 BOVET ROAD, SUITE 103
    SAN MATEO, CA
    ZIP 94402
  • Facility Phone: 650 570-0529
  • Facility Type: Ambulatory Surgery Center
  • Facility Type: Waiver
  • Lab Director: MARK SONTAG
  • NPI Number: 1750553376
  • Taxonomy: 261QA1903X - Clinic/Center

Map and Directions

Get Directions

CLIA Record

Field Name Field Value
CLIA Number 05D1090125
LAB Type Ambulatory Surgery Center
Facility Name SAN MATEO SURGERY CENTER
Street 66 BOVET ROAD, SUITE 103
City SAN MATEO
State CA
ZIP 94402
Phone 650 570-0529
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 10/2/2024
Certificate Expiration Date 10/1/2026
Facility Type Ambulatory Surgery Center
Lab Director MARK SONTAG

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