05D1050971 CLIA NUMBER - SIERRA AMBULATORY SURGERY CENTER

Laboratory Demographics

  • CLIA Code: 05D1050971
  • Facility Name: SIERRA AMBULATORY SURGERY CENTER
  • Facility Address: 400 SIERRA COLLEGE DRIVE, STE B
    GRASS VALLEY, CA
    ZIP 95945
  • Facility Phone: 530 272-3428
  • Facility Type: Ambulatory Surgery Center
  • Facility Type: Waiver
  • Lab Director: GREGORY J. PORTER, MD
  • NPI Number: 1043254063
  • Taxonomy: 261QA1903X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 05D1050971
LAB Type Ambulatory Surgery Center
Facility Name SIERRA AMBULATORY SURGERY CENTER
Street 400 SIERRA COLLEGE DRIVE, STE B
City GRASS VALLEY
State CA
ZIP 95945
Phone 530 272-3428
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 2/16/2024
Certificate Expiration Date 2/15/2026
Facility Type Ambulatory Surgery Center
Lab Director GREGORY J. PORTER, MD

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