05D0936932 CLIA NUMBER - PREMIERE SURGERY CENTER

Laboratory Demographics

  • CLIA Code: 05D0936932
  • Facility Name: PREMIERE SURGERY CENTER
  • Facility Address: 700 W EL NORTE PARKWAY
    ESCONDIDO, CA
    ZIP 92026
  • Facility Phone: 760 738-7832
  • Facility Type: Ambulatory Surgery Center
  • Facility Type: Waiver
  • Lab Director: R K. MASSENGIL
  • NPI Number: 1043268840
  • Taxonomy: 261QA1903X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 05D0936932
LAB Type Ambulatory Surgery Center
Facility Name PREMIERE SURGERY CENTER
Street 700 W EL NORTE PARKWAY
City ESCONDIDO
State CA
ZIP 92026
Phone 760 738-7832
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 12/4/2023
Certificate Expiration Date 12/3/2025
Facility Type Ambulatory Surgery Center
Lab Director R K. MASSENGIL

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