05D1028357 CLIA NUMBER - SCRIPPS MERCY AMBULATORY SURGERY CENTER

Laboratory Demographics

CLIA Number: 05D1028357

Facility Name: SCRIPPS MERCY AMBULATORY SURGERY CENTER

Facility Address:
550 WASHINGTON ST SUTE 101
SAN DIEGO, CA
ZIP 92103
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Facility Phone Number: 619 686-3434

Facility Type: Ambulatory Surgery Center

Certificate Type: Waiver

NPI Number: 1972668317

Taxonomy: 261QA1903X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	05D1028357
LAB Type	Ambulatory Surgery Center
Facility Name	SCRIPPS MERCY AMBULATORY SURGERY CENTER
Street	550 WASHINGTON ST SUTE 101
City	SAN DIEGO
State	CA
ZIP	92103
Phone	619 686-3434
CertificateType	4
CertificateEffectiveDate	8/23/2022
CertificateExpirationDate	8/22/2024
FacilityType	Waiver

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