05D1030089 CLIA NUMBER - ADVANCED SURGICAL INSTITUTE,THE

Laboratory Demographics

  • CLIA Code: 05D1030089
  • Facility Name: ADVANCED SURGICAL INSTITUTE,THE
  • Facility Address: 19671 BEACH BLVD STE 300
    HUNTINGTON BEACH, CA
    ZIP 92648
  • Facility Phone: 714 962-2520
  • Facility Type: Ambulatory Surgery Center
  • Facility Type: Waiver
  • Lab Director: MAZIN AL-HAKEEM MD
  • NPI Number: 1518405166
  • Taxonomy: 251S00000X - Community/Behavioral Health

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CLIA Record

Field Name Field Value
CLIA Number 05D1030089
LAB Type Ambulatory Surgery Center
Facility Name ADVANCED SURGICAL INSTITUTE,THE
Street 19671 BEACH BLVD STE 300
City HUNTINGTON BEACH
State CA
ZIP 92648
Phone 714 962-2520
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 11/7/2023
Certificate Expiration Date 11/6/2025
Facility Type Ambulatory Surgery Center
Lab Director MAZIN AL-HAKEEM MD

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