05D1001420 CLIA NUMBER - PACIFIC SURGERY CENTER

Laboratory Demographics

CLIA Number: 05D1001420

Facility Name: PACIFIC SURGERY CENTER

Facility Address:
3998 VISTA WY STE C106
OCEANSIDE, CA
ZIP 92056
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Facility Phone Number: 760 941-2600

Facility Type: Ambulatory Surgery Center

Certificate Type: Waiver

NPI Number: 1699863258

Taxonomy: 261QA1903X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	05D1001420
LAB Type	Ambulatory Surgery Center
Facility Name	PACIFIC SURGERY CENTER
Street	3998 VISTA WY STE C106
City	OCEANSIDE
State	CA
ZIP	92056
Phone	760 941-2600
CertificateType	4
CertificateEffectiveDate	7/10/2022
CertificateExpirationDate	7/9/2024
FacilityType	Waiver

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