05D1059354 CLIA NUMBER - AVANGUARD SURGERY CENTER

Laboratory Demographics

  • CLIA Code: 05D1059354
  • Facility Name: AVANGUARD SURGERY CENTER
  • Facility Address: 5620 WILBUR AVE STE 207
    TARZANA, CA
    ZIP 91356
  • Facility Phone: 818 344-0070
  • Facility Type: Ambulatory Surgery Center
  • Facility Type: Waiver
  • Lab Director: KEVIN A. NADEL
  • NPI Number: 1336746221
  • Taxonomy: 2471V0106X - Radiologic Technologist

Map and Directions

Get Directions

CLIA Record

Field Name Field Value
CLIA Number 05D1059354
LAB Type Ambulatory Surgery Center
Facility Name AVANGUARD SURGERY CENTER
Street 5620 WILBUR AVE STE 207
City TARZANA
State CA
ZIP 91356
Phone 818 344-0070
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 9/27/2024
Certificate Expiration Date 9/26/2026
Facility Type Ambulatory Surgery Center
Lab Director KEVIN A. NADEL

Download Record

Download this CLIA record record in Text format: Export

Download this CLIA record record in Excel (CSV) format: Export

Download this CLIA record record in XML format: Export

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