05D0866141 CLIA NUMBER - M/S SURGERY CENTER, LLC

Laboratory Demographics

CLIA Number: 05D0866141

Facility Name: M/S SURGERY CENTER, LLC

Facility Address:
3510 MARTIN LUTHER KING JR BLVD
LYNWOOD, CA
ZIP 90262
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Facility Phone Number: 310 638-9391

Facility Type: Ambulatory Surgery Center

Certificate Type: Waiver

NPI Number: 1831109875

Taxonomy: 261QA1903X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	05D0866141
LAB Type	Ambulatory Surgery Center
Facility Name	M/S SURGERY CENTER, LLC
Street	3510 MARTIN LUTHER KING JR BLVD
City	LYNWOOD
State	CA
ZIP	90262
Phone	310 638-9391
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