05D1065144 CLIA NUMBER - AZUSA SURGERY CENTER INC A MEDICAL CORPORATION

Laboratory Demographics

  • CLIA Code: 05D1065144
  • Facility Name: AZUSA SURGERY CENTER INC A MEDICAL CORPORATION
  • Facility Address: 830 S CITRUS AVE STE 101
    AZUSA, CA
    ZIP 91702
  • Facility Phone: 626 543-1560
  • Facility Type: Ambulatory Surgery Center
  • Facility Type: Waiver
  • Lab Director: MARC E. LYNCH
  • NPI Number: 1114043858
  • Taxonomy: 261QA1903X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 05D1065144
LAB Type Ambulatory Surgery Center
Facility Name AZUSA SURGERY CENTER INC A MEDICAL CORPORATION
Street 830 S CITRUS AVE STE 101
City AZUSA
State CA
ZIP 91702
Phone 626 543-1560
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 2/22/2025
Certificate Expiration Date 2/21/2027
Facility Type Ambulatory Surgery Center
Lab Director MARC E. LYNCH

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