05D1002085 CLIA NUMBER - MAIN STREET SPECIALTY SURGERY CENTER LLC

Home > CLIA Lookup > 05D1002085

Laboratory Demographics

CLIA Number: 05D1002085

Facility Name: MAIN STREET SPECIALTY SURGERY CENTER LLC

Facility Address:
280 S MAIN ST, STE 100
ORANGE, CA
ZIP 92868
Get Directions

Facility Phone Number: 714 704-1900

Facility Type: Ambulatory Surgery Center

Certificate Type: Waiver

NPI Number: 1225275688

Taxonomy: 261QA1903X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	05D1002085
LAB Type	Ambulatory Surgery Center
Facility Name	MAIN STREET SPECIALTY SURGERY CENTER LLC
Street	280 S MAIN ST, STE 100
City	ORANGE
State	CA
ZIP	92868
Phone	714 704-1900
CertificateType	4
CertificateEffectiveDate	7/29/2022
CertificateExpirationDate	7/28/2024
FacilityType	Waiver

Download Record

Export to text format icon Download this CLIA NUMBER record in Text format: Export

Export to text format icon Download this CLIA NUMBER record in Excel (CSV) format: Export

Export to text format icon Download this CLIA NUMBER record in XML format: Export

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