05D0956236 CLIA NUMBER - PLASTIC SURGERY CENTER LLC

Laboratory Demographics

CLIA Number: 05D0956236

Facility Name: PLASTIC SURGERY CENTER LLC

Facility Address:
1515 EL CAMINO REAL STE A
PALO ALTO, CA
ZIP 94306
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Facility Phone Number: (650) 322-6291

Facility Type: AMBULATORY SURGERY CENTER

Certificate Type: Waiver

NPI Number: 1477675841

Taxonomy: 261QA1903X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	05D0956236
LAB Type	AMBULATORY SURGERY CENTER
Facility Name	PLASTIC SURGERY CENTER LLC
Street	1515 EL CAMINO REAL STE A
City	PALO ALTO
State	CA
ZIP	94306
Phone	(650) 322-6291

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This page was last updated on: 5/11/2023