05D0986727 CLIA NUMBER - PREMIER OUTPATIENT SURGERY CENTER

Laboratory Demographics

  • CLIA Code: 05D0986727
  • Facility Name: PREMIER OUTPATIENT SURGERY CENTER
  • Facility Address: 1003 E BRIER DR, STE 170
    SAN BERNARDINO, CA
    ZIP 92408
  • Facility Phone: 909 370-2190
  • Facility Type: Ambulatory Surgery Center
  • Facility Type: Waiver
  • Lab Director: JIENSUP KIM
  • NPI Number: 1629313739
  • Taxonomy: 261QA1903X - Clinic/Center

Map and Directions

Get Directions

CLIA Record

Field Name Field Value
CLIA Number 05D0986727
LAB Type Ambulatory Surgery Center
Facility Name PREMIER OUTPATIENT SURGERY CENTER
Street 1003 E BRIER DR, STE 170
City SAN BERNARDINO
State CA
ZIP 92408
Phone 909 370-2190
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 5/22/2025
Certificate Expiration Date 5/21/2027
Facility Type Ambulatory Surgery Center
Lab Director JIENSUP KIM

Download Record

Download this CLIA record record in Text format: Export

Download this CLIA record record in Excel (CSV) format: Export

Download this CLIA record record in XML format: Export

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