05D1001728 CLIA NUMBER - PASADENA ENDOSCOPY CENTER INC

Laboratory Demographics

  • CLIA Code: 05D1001728
  • Facility Name: PASADENA ENDOSCOPY CENTER INC
  • Facility Address: 55 WEST VALLEY STREET
    PASADENA, CA
    ZIP 91105
  • Facility Phone: 626 793-9900
  • Facility Type: Ambulatory Surgery Center
  • Facility Type: Waiver
  • Lab Director: RICHARD E. NICKOWITZ
  • NPI Number: 1336247642
  • Taxonomy: 261QE0800X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 05D1001728
LAB Type Ambulatory Surgery Center
Facility Name PASADENA ENDOSCOPY CENTER INC
Street 55 WEST VALLEY STREET
City PASADENA
State CA
ZIP 91105
Phone 626 793-9900
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 7/18/2024
Certificate Expiration Date 7/17/2026
Facility Type Ambulatory Surgery Center
Lab Director RICHARD E. NICKOWITZ

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