05D1017466 CLIA NUMBER - CHICO SURGICAL AFFILIATES

Laboratory Demographics

CLIA Number: 05D1017466

Facility Name: CHICO SURGICAL AFFILIATES

Facility Address:
615 W EAST AVE
CHICO, CA
ZIP 95926
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Facility Phone Number: 530 487-8114

Facility Type: Ambulatory Surgery Center

Certificate Type: Waiver

NPI Number: 1164421004

Taxonomy: 261QA1903X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	05D1017466
LAB Type	Ambulatory Surgery Center
Facility Name	CHICO SURGICAL AFFILIATES
Street	615 W EAST AVE
City	CHICO
State	CA
ZIP	95926
Phone	530 487-8114
CertificateType	4
CertificateEffectiveDate	9/25/2023
CertificateExpirationDate	9/24/2025
FacilityType	Waiver

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