05D0984346 CLIA NUMBER - MILE SQUARE SURGERY CENTER, INC

Laboratory Demographics

  • CLIA Code: 05D0984346
  • Facility Name: MILE SQUARE SURGERY CENTER, INC
  • Facility Address: 10760 WARNER AVENUE #102
    FOUNTAIN VALLEY, CA
    ZIP 92708
  • Facility Phone: 714 274-0388
  • Facility Type: Ambulatory Surgery Center
  • Facility Type: Waiver
  • Lab Director: DOUGLAS A. TRAN MD
  • NPI Number: 1447255435
  • Taxonomy: 261QA1903X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 05D0984346
LAB Type Ambulatory Surgery Center
Facility Name MILE SQUARE SURGERY CENTER, INC
Street 10760 WARNER AVENUE #102
City FOUNTAIN VALLEY
State CA
ZIP 92708
Phone 714 274-0388
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 3/20/2025
Certificate Expiration Date 3/19/2027
Facility Type Ambulatory Surgery Center
Lab Director DOUGLAS A. TRAN MD

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