05D0574069 CLIA NUMBER - INLAND SURGERY CENTER

Laboratory Demographics

CLIA Number: 05D0574069

Facility Name: INLAND SURGERY CENTER

Facility Address:
1620 LAUREL AVE
REDLANDS, CA
ZIP 92373
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Facility Phone Number: (909) 793-4701

Facility Type: AMBULATORY SURGERY CENTER

Certificate Type: Waiver

NPI Number: 1942265939

Taxonomy: 261QA1903X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	05D0574069
LAB Type	AMBULATORY SURGERY CENTER
Facility Name	INLAND SURGERY CENTER
Street	1620 LAUREL AVE
City	REDLANDS
State	CA
ZIP	92373
Phone	(909) 793-4701

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This page was last updated on: 5/11/2023