05D1010403 CLIA NUMBER - NEWPORT SURGICAL PARTNERS, LLC DBA NEWPORT PLAZA SURGICAL CENTER

Laboratory Demographics

  • CLIA Code: 05D1010403
  • Facility Name: NEWPORT SURGICAL PARTNERS, LLC DBA NEWPORT PLAZA SURGICAL CENTER
  • Facility Address: 1901 NEWPORT BLVD SUITE 120
    COSTA MESA, CA
    ZIP 92627
  • Facility Phone: 949 515-1040
  • Facility Type: Ambulatory Surgery Center
  • Facility Type: Waiver
  • Lab Director: THEODORE QUILLIGAN
  • NPI Number: 1003138736
  • Taxonomy: 261QA1903X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 05D1010403
LAB Type Ambulatory Surgery Center
Facility Name NEWPORT SURGICAL PARTNERS, LLC DBA NEWPORT PLAZA SURGICAL CENTER
Street 1901 NEWPORT BLVD SUITE 120
City COSTA MESA
State CA
ZIP 92627
Phone 949 515-1040
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 3/12/2025
Certificate Expiration Date 3/11/2027
Facility Type Ambulatory Surgery Center
Lab Director THEODORE QUILLIGAN

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