05D2202964 CLIA NUMBER - ABROMS DOUGHERTY VISION ASC LLC

Laboratory Demographics

  • CLIA Code: 05D2202964
  • Facility Name: ABROMS DOUGHERTY VISION ASC LLC
  • Facility Address: 4472 BROAD ST # 150
    SAN LUIS OBISPO, CA
    ZIP 93401
  • Facility Phone: 805 545-8100
  • Facility Type: Ambulatory Surgery Center
  • Facility Type: Waiver
  • Lab Director: ADAMD D. ABROMS
  • NPI Number: 1790384303
  • Taxonomy: 261QA1903X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 05D2202964
LAB Type Ambulatory Surgery Center
Facility Name ABROMS DOUGHERTY VISION ASC LLC
Street 4472 BROAD ST # 150
City SAN LUIS OBISPO
State CA
ZIP 93401
Phone 805 545-8100
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 12/2/2024
Certificate Expiration Date 12/1/2026
Facility Type Ambulatory Surgery Center
Lab Director ADAMD D. ABROMS

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