05D1070564 CLIA NUMBER - PENINSULA PLASTIC SURGERY CENTER

Laboratory Demographics

  • CLIA Code: 05D1070564
  • Facility Name: PENINSULA PLASTIC SURGERY CENTER
  • Facility Address: 3400 W LOMITA BLVD STE #306
    TORRANCE, CA
    ZIP 90505
  • Facility Phone: 310 326-3636
  • Facility Type: Ambulatory Surgery Center
  • Facility Type: Waiver
  • Lab Director: RONALD F. ROSSO MD
  • NPI Number: 1659947455
  • Taxonomy: 261QU0200X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 05D1070564
LAB Type Ambulatory Surgery Center
Facility Name PENINSULA PLASTIC SURGERY CENTER
Street 3400 W LOMITA BLVD STE #306
City TORRANCE
State CA
ZIP 90505
Phone 310 326-3636
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 7/2/2025
Certificate Expiration Date 7/1/2027
Facility Type Ambulatory Surgery Center
Lab Director RONALD F. ROSSO MD

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