05D1105033 CLIA NUMBER - FREEDOM VISION SURGERY CENTER

Laboratory Demographics

  • CLIA Code: 05D1105033
  • Facility Name: FREEDOM VISION SURGERY CENTER
  • Facility Address: 16255 VENTURA BLVD #100
    ENCINO, CA
    ZIP 91436
  • Facility Phone: 818 783-2346
  • Facility Type: Ambulatory Surgery Center
  • Facility Type: Waiver
  • Lab Director: MICHAEL COLVARD, MD
  • NPI Number: 1669414306
  • Taxonomy: 261QA1903X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 05D1105033
LAB Type Ambulatory Surgery Center
Facility Name FREEDOM VISION SURGERY CENTER
Street 16255 VENTURA BLVD #100
City ENCINO
State CA
ZIP 91436
Phone 818 783-2346
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 9/15/2025
Certificate Expiration Date 9/14/2027
Facility Type Ambulatory Surgery Center
Lab Director MICHAEL COLVARD, MD

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