05D0864724 CLIA NUMBER - LOS ROBLES SURGICENTER, LLC

Laboratory Demographics

  • CLIA Code: 05D0864724
  • Facility Name: LOS ROBLES SURGICENTER, LLC
  • Facility Address: 2190 LYNN ROAD SUITE #100
    THOUSAND OAKS, CA
    ZIP 91360
  • Facility Phone: 805 497-3737
  • Facility Type: Ambulatory Surgery Center
  • Facility Type: Waiver
  • Lab Director: RICHARD HOBERMAN
  • NPI Number: 1336294859
  • Taxonomy: 261QA1903X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 05D0864724
LAB Type Ambulatory Surgery Center
Facility Name LOS ROBLES SURGICENTER, LLC
Street 2190 LYNN ROAD SUITE #100
City THOUSAND OAKS
State CA
ZIP 91360
Phone 805 497-3737
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 RICHARD HOBERMAN

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