05D1036772 CLIA NUMBER - PACIFIC ENDOSCOPY AND SURGERY CENTER, LLC

Laboratory Demographics

  • CLIA Code: 05D1036772
  • Facility Name: PACIFIC ENDOSCOPY AND SURGERY CENTER, LLC
  • Facility Address: 17815 NEWHOPE STREET SUITE R
    FOUNTAIN VALLEY, CA
    ZIP 92708
  • Facility Phone: 714 432-8881
  • Facility Type: Ambulatory Surgery Center
  • Facility Type: Waiver
  • Lab Director: SURINDER S. SAINI MD
  • NPI Number: 1104006006
  • Taxonomy: 261QA1903X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 05D1036772
LAB Type Ambulatory Surgery Center
Facility Name PACIFIC ENDOSCOPY AND SURGERY CENTER, LLC
Street 17815 NEWHOPE STREET SUITE R
City FOUNTAIN VALLEY
State CA
ZIP 92708
Phone 714 432-8881
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 2/9/2025
Certificate Expiration Date 2/8/2027
Facility Type Ambulatory Surgery Center
Lab Director SURINDER S. SAINI MD

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