05D2170065 CLIA NUMBER - DEAN AMUNDSEN, OD PROF OPTOMETRY CORP

Laboratory Demographics

  • CLIA Code: 05D2170065
  • Facility Name: DEAN AMUNDSEN, OD PROF OPTOMETRY CORP
  • Facility Address: 4000 CALLE TECATE, SUTIE 100
    CAMARILLO, CA
    ZIP 93012
  • Facility Phone: 805 482-1136
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: DEAN K. AMUNDSEN
  • NPI Number: 1003021205
  • Taxonomy: 152W00000X - Optometrist

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CLIA Record

Field Name Field Value
CLIA Number 05D2170065
LAB Type Physician Office
Facility Name DEAN AMUNDSEN, OD PROF OPTOMETRY CORP
Street 4000 CALLE TECATE, SUTIE 100
City CAMARILLO
State CA
ZIP 93012
Phone 805 482-1136
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 8/1/2023
Certificate Expiration Date 7/31/2025
Facility Type Physician Office
Lab Director DEAN K. AMUNDSEN

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This page was last updated on: 6/4/2025