05D0904143 CLIA NUMBER - SANTA ROSA SURGERY CENTER, LP

Laboratory Demographics

  • CLIA Code: 05D0904143
  • Facility Name: SANTA ROSA SURGERY CENTER, LP
  • Facility Address: 34 MARK WEST SPRINGS RD STE 100
    SANTA ROSA, CA
    ZIP 95403
  • Facility Phone: 707 541-3503
  • Facility Type: Ambulatory Surgery Center
  • Facility Type: Waiver
  • Lab Director: DARIN D. BRUNSON
  • NPI Number: 1285631978
  • Taxonomy: 261QM2800X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 05D0904143
LAB Type Ambulatory Surgery Center
Facility Name SANTA ROSA SURGERY CENTER, LP
Street 34 MARK WEST SPRINGS RD STE 100
City SANTA ROSA
State CA
ZIP 95403
Phone 707 541-3503
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 8/9/2025
Certificate Expiration Date 8/8/2027
Facility Type Ambulatory Surgery Center
Lab Director DARIN D. BRUNSON

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