05D1035053 CLIA NUMBER - ADVANCED ENDOSCOPY AND PAIN CENTER LLC

Laboratory Demographics

  • CLIA Code: 05D1035053
  • Facility Name: ADVANCED ENDOSCOPY AND PAIN CENTER LLC
  • Facility Address: 1753 W AVENUE J, STE A
    LANCASTER, CA
    ZIP 93534
  • Facility Phone: 661 206-0555
  • Facility Type: Ambulatory Surgery Center
  • Facility Type: Waiver
  • Lab Director: CHIDAMPARANATHA THIAGARAJAH
  • NPI Number: 1205195716
  • Taxonomy: 261QA1903X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 05D1035053
LAB Type Ambulatory Surgery Center
Facility Name ADVANCED ENDOSCOPY AND PAIN CENTER LLC
Street 1753 W AVENUE J, STE A
City LANCASTER
State CA
ZIP 93534
Phone 661 206-0555
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 12/20/2024
Certificate Expiration Date 12/19/2026
Facility Type Ambulatory Surgery Center
Lab Director CHIDAMPARANATHA THIAGARAJAH

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