05D1018686 CLIA NUMBER - PACIFIC SURGERY CENTER OF VENTURA

Laboratory Demographics

  • CLIA Code: 05D1018686
  • Facility Name: PACIFIC SURGERY CENTER OF VENTURA
  • Facility Address: 3805 TELEGRAPH RD
    VENTURA, CA
    ZIP 93003
  • Facility Phone: 805 644-9001
  • Facility Type: Ambulatory Surgery Center
  • Facility Type: Waiver
  • Lab Director: BRYANT J. LUM
  • NPI Number: 1073693123
  • Taxonomy: 261QA1903X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 05D1018686
LAB Type Ambulatory Surgery Center
Facility Name PACIFIC SURGERY CENTER OF VENTURA
Street 3805 TELEGRAPH RD
City VENTURA
State CA
ZIP 93003
Phone 805 644-9001
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 10/29/2023
Certificate Expiration Date 10/28/2025
Facility Type Ambulatory Surgery Center
Lab Director BRYANT J. LUM

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