05D1077545 CLIA NUMBER - PRISTINE SURGERY CENTER, INC

Laboratory Demographics

  • CLIA Code: 05D1077545
  • Facility Name: PRISTINE SURGERY CENTER, INC
  • Facility Address: 7085 N MAPLE AVE
    FRESNO, CA
    ZIP 93720
  • Facility Phone: 559 273-0600
  • Facility Type: Ambulatory Surgery Center
  • Facility Type: Waiver
  • Lab Director: PRAHALAD B. JAJODIA, MD
  • NPI Number: 1831371749
  • Taxonomy: 261QA1903X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 05D1077545
LAB Type Ambulatory Surgery Center
Facility Name PRISTINE SURGERY CENTER, INC
Street 7085 N MAPLE AVE
City FRESNO
State CA
ZIP 93720
Phone 559 273-0600
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 12/12/2023
Certificate Expiration Date 12/11/2025
Facility Type Ambulatory Surgery Center
Lab Director PRAHALAD B. JAJODIA, MD

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