05D0725602 CLIA NUMBER - GROSSMONT SURGERY CENTER

Laboratory Demographics

  • CLIA Code: 05D0725602
  • Facility Name: GROSSMONT SURGERY CENTER
  • Facility Address: 8881 FLETCHER PARKWAY, STE 100
    LA MESA, CA
    ZIP 91942
  • Facility Phone: 619 698-0930
  • Facility Type: Ambulatory Surgery Center
  • Facility Type: Waiver
  • Lab Director: RONALD M. LEVIN
  • NPI Number: 1326004110
  • Taxonomy: 261QA1903X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 05D0725602
LAB Type Ambulatory Surgery Center
Facility Name GROSSMONT SURGERY CENTER
Street 8881 FLETCHER PARKWAY, STE 100
City LA MESA
State CA
ZIP 91942
Phone 619 698-0930
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 9/1/2024
Certificate Expiration Date 8/31/2026
Facility Type Ambulatory Surgery Center
Lab Director RONALD M. LEVIN

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