05D0606143 CLIA NUMBER - LOS GATOS SURGICAL CTR

Laboratory Demographics

CLIA Number: 05D0606143

Facility Name: LOS GATOS SURGICAL CTR

Facility Address:
15195 NATIONAL AVE 100
LOS GATOS, CA
ZIP 95032
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Facility Phone Number: 408 356-0454

Facility Type: Ambulatory Surgery Center

Certificate Type: Waiver

NPI Number: 1801859970

Taxonomy: 261QA1903X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	05D0606143
LAB Type	Ambulatory Surgery Center
Facility Name	LOS GATOS SURGICAL CTR
Street	15195 NATIONAL AVE 100
City	LOS GATOS
State	CA
ZIP	95032
Phone	408 356-0454
CertificateType	4
CertificateEffectiveDate	9/1/2022
CertificateExpirationDate	8/31/2024
FacilityType	Waiver

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This page was last updated on: 4/23/2024