05D1027424 CLIA NUMBER - FULLERTON SURGICAL CENTER A CALIFORNIA LIMITED PARTNERSHIP

Laboratory Demographics

  • CLIA Code: 05D1027424
  • Facility Name: FULLERTON SURGICAL CENTER A CALIFORNIA LIMITED PARTNERSHIP
  • Facility Address: 2240 N HARBOR BLVD STE 100
    FULLERTON, CA
    ZIP 92835
  • Facility Phone: 714 870-8300
  • Facility Type: Ambulatory Surgery Center
  • Facility Type: Waiver
  • Lab Director: KAVEH MATIN
  • NPI Number: 1962423574
  • Taxonomy: 261QA1903X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 05D1027424
LAB Type Ambulatory Surgery Center
Facility Name FULLERTON SURGICAL CENTER A CALIFORNIA LIMITED PARTNERSHIP
Street 2240 N HARBOR BLVD STE 100
City FULLERTON
State CA
ZIP 92835
Phone 714 870-8300
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 6/29/2024
Certificate Expiration Date 6/28/2026
Facility Type Ambulatory Surgery Center
Lab Director KAVEH MATIN

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