Foxconn WFU03

"C1209-A1" and "PCB1P-112BJ07-20SA" is silkscreened on the board by the PCIe connector in the FCC photos.
 * This device would appear to be using MT7601UN.

The FCC EUT's label shows the module w/ a 00:1A:5D (Mobinnova) OUI.

It's used in some VIZIO equipment, though possibly other branded equipment as well..