05D2195645 CLIA NUMBER - DLV VISION ASC, LLC

Laboratory Demographics

  • CLIA Code: 05D2195645
  • Facility Name: DLV VISION ASC, LLC
  • Facility Address: 3180 WILLOW LANE, #116
    THOUSAND OAKS, CA
    ZIP 91361
  • Facility Phone: 805 987-5300
  • Facility Type: Ambulatory Surgery Center
  • Facility Type: Waiver
  • Lab Director: PAUL DOUGHERTY
  • NPI Number: 1609245380
  • Taxonomy: 152W00000X - Optometrist

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CLIA Record

Field Name Field Value
CLIA Number 05D2195645
LAB Type Ambulatory Surgery Center
Facility Name DLV VISION ASC, LLC
Street 3180 WILLOW LANE, #116
City THOUSAND OAKS
State CA
ZIP 91361
Phone 805 987-5300
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 10/11/2024
Certificate Expiration Date 10/10/2026
Facility Type Ambulatory Surgery Center
Lab Director PAUL DOUGHERTY

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