05D1061667 CLIA NUMBER - DAMERON HOSPITAL ASSOCIATION ALEX & FAYE SURGICAL PAVILION

Laboratory Demographics

  • CLIA Code: 05D1061667
  • Facility Name: DAMERON HOSPITAL ASSOCIATION ALEX & FAYE SURGICAL PAVILION
  • Facility Address: 445 WEST ACACIA ST
    STOCKTON, CA
    ZIP 95203
  • Facility Phone: 209 461-3151
  • Facility Type: Ambulatory Surgery Center
  • Facility Type: Waiver
  • Lab Director: ELVIRA A. MILANO
  • NPI Number: 1538163886
  • Taxonomy: 282N00000X - General Acute Care Hospital

Map and Directions

Get Directions

CLIA Record

Field Name Field Value
CLIA Number 05D1061667
LAB Type Ambulatory Surgery Center
Facility Name DAMERON HOSPITAL ASSOCIATION ALEX & FAYE SURGICAL PAVILION
Street 445 WEST ACACIA ST
City STOCKTON
State CA
ZIP 95203
Phone 209 461-3151
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 11/22/2024
Certificate Expiration Date 11/21/2026
Facility Type Ambulatory Surgery Center
Lab Director ELVIRA A. MILANO

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