05D1032654 CLIA NUMBER - LYNN EYE SURGERY, LLC

Laboratory Demographics

CLIA Number: 05D1032654

Facility Name: LYNN EYE SURGERY, LLC

Facility Address:
2230 LYNN ROAD #106
THOUSAND OAKS, CA
ZIP 91360
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Facility Phone Number: 949 996-5795

Facility Type: Ambulatory Surgery Center

Certificate Type: Waiver

NPI Number: 1255472841

Taxonomy: 261QA1903X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	05D1032654
LAB Type	Ambulatory Surgery Center
Facility Name	LYNN EYE SURGERY, LLC
Street	2230 LYNN ROAD #106
City	THOUSAND OAKS
State	CA
ZIP	91360
Phone	949 996-5795
CertificateType	4
CertificateEffectiveDate	10/15/2022
CertificateExpirationDate	10/14/2024
FacilityType	Waiver

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