05D1019467 CLIA NUMBER - NEWPORT CENTER SURGICAL

Laboratory Demographics

  • CLIA Code: 05D1019467
  • Facility Name: NEWPORT CENTER SURGICAL
  • Facility Address: 17 CORPORATE PLAZA DR STE 120
    NEWPORT BEACH, CA
    ZIP 92660
  • Facility Phone: 949 706-6300
  • Facility Type: Ambulatory Surgery Center
  • Facility Type: Waiver
  • Lab Director: EDWARD S. LEE
  • NPI Number: 1508896200
  • Taxonomy: 261QA1903X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 05D1019467
LAB Type Ambulatory Surgery Center
Facility Name NEWPORT CENTER SURGICAL
Street 17 CORPORATE PLAZA DR STE 120
City NEWPORT BEACH
State CA
ZIP 92660
Phone 949 706-6300
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 11/19/2023
Certificate Expiration Date 11/18/2025
Facility Type Ambulatory Surgery Center
Lab Director EDWARD S. LEE

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