05D1035049 CLIA NUMBER - NATRAJ SURGERY CENTER INC

Laboratory Demographics

CLIA Number: 05D1035049

Facility Name: NATRAJ SURGERY CENTER INC

Facility Address:
555 W PUTNAM AVE
PORTERVILLE, CA
ZIP 93257
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Facility Phone Number: 559 782-8533

Facility Type: Ambulatory Surgery Center

Certificate Type: Waiver

NPI Number: 1083711568

Taxonomy: 261QA1903X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	05D1035049
LAB Type	Ambulatory Surgery Center
Facility Name	NATRAJ SURGERY CENTER INC
Street	555 W PUTNAM AVE
City	PORTERVILLE
State	CA
ZIP	93257
Phone	559 782-8533
CertificateType	4
CertificateEffectiveDate	12/20/2022
CertificateExpirationDate	12/19/2024
FacilityType	Waiver

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