05D0953985 CLIA NUMBER - UPLAND OUTPATIENT SURGICAL CENTER, LP

Laboratory Demographics

  • CLIA Code: 05D0953985
  • Facility Name: UPLAND OUTPATIENT SURGICAL CENTER, LP
  • Facility Address: 1211 W 6TH ST
    ONTARIO, CA
    ZIP 91762
  • Facility Phone: 909 247-9483
  • Facility Type: Ambulatory Surgery Center
  • Facility Type: Waiver
  • Lab Director: THOMAS T. EASTER MD
  • NPI Number: 1710945787
  • Taxonomy: 261QA1903X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 05D0953985
LAB Type Ambulatory Surgery Center
Facility Name UPLAND OUTPATIENT SURGICAL CENTER, LP
Street 1211 W 6TH ST
City ONTARIO
State CA
ZIP 91762
Phone 909 247-9483
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 2/29/2024
Certificate Expiration Date 2/27/2026
Facility Type Ambulatory Surgery Center
Lab Director THOMAS T. EASTER MD

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