05D0914356 CLIA NUMBER - LA VETA SURGICAL CENTER

Laboratory Demographics

  • CLIA Code: 05D0914356
  • Facility Name: LA VETA SURGICAL CENTER
  • Facility Address: 681 S PARKER ST STE 150
    ORANGE, CA
    ZIP 92868
  • Facility Phone: 714 744-0900
  • Facility Type: Ambulatory Surgery Center
  • Facility Type: Waiver
  • Lab Director: PHILLIP J. RICHARDSON
  • NPI Number: 1619340148
  • Taxonomy: 261QA1903X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 05D0914356
LAB Type Ambulatory Surgery Center
Facility Name LA VETA SURGICAL CENTER
Street 681 S PARKER ST STE 150
City ORANGE
State CA
ZIP 92868
Phone 714 744-0900
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 4/26/2024
Certificate Expiration Date 4/25/2026
Facility Type Ambulatory Surgery Center
Lab Director PHILLIP J. RICHARDSON

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