05D0950889 CLIA NUMBER - COAST SURGERY CENTER DBA COAST SURGERY CENTER

Laboratory Demographics

CLIA Number: 05D0950889

Facility Name: COAST SURGERY CENTER DBA COAST SURGERY CENTER

Facility Address:
3444 KEARNY VILLA ROAD STE 100
SAN DIEGO, CA
ZIP 92123
Get Directions

Facility Phone Number: 858 268-3566

Facility Type: Ambulatory Surgery Center

Certificate Type: Waiver

NPI Number: 1386748440

Taxonomy: 261QA1903X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	05D0950889
LAB Type	Ambulatory Surgery Center
Facility Name	COAST SURGERY CENTER DBA COAST SURGERY CENTER
Street	3444 KEARNY VILLA ROAD STE 100
City	SAN DIEGO
State	CA
ZIP	92123
Phone	858 268-3566
CertificateType	4
CertificateEffectiveDate	9/9/2022
CertificateExpirationDate	9/8/2024
FacilityType	Waiver

Download Record

Export to text format icon Download this CLIA NUMBER record in Text format: Export

Export to text format icon Download this CLIA NUMBER record in Excel (CSV) format: Export

Export to text format icon Download this CLIA NUMBER record in XML format: Export

This page was last updated on: 4/23/2024