05D1035143 CLIA NUMBER - ADVANCED AMBULATORY SURGERY CENTER

Laboratory Demographics

  • CLIA Code: 05D1035143
  • Facility Name: ADVANCED AMBULATORY SURGERY CENTER
  • Facility Address: 1901 W LUGONIA AVE STE 100
    REDLANDS, CA
    ZIP 92374
  • Facility Phone: 909 557-1700
  • Facility Type: Ambulatory Surgery Center
  • Facility Type: Waiver
  • Lab Director: PAUL KIM
  • NPI Number: 1881690949
  • Taxonomy: 261QA1903X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 05D1035143
LAB Type Ambulatory Surgery Center
Facility Name ADVANCED AMBULATORY SURGERY CENTER
Street 1901 W LUGONIA AVE STE 100
City REDLANDS
State CA
ZIP 92374
Phone 909 557-1700
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 12/21/2024
Certificate Expiration Date 12/20/2026
Facility Type Ambulatory Surgery Center
Lab Director PAUL KIM

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