05D1077958 CLIA NUMBER - HERNDON SURGERY CENTER

Laboratory Demographics

  • CLIA Code: 05D1077958
  • Facility Name: HERNDON SURGERY CENTER
  • Facility Address: 1843 E FIR AVE STE 104
    FRESNO, CA
    ZIP 93720
  • Facility Phone: 559 323-6611
  • Facility Type: Ambulatory Surgery Center
  • Facility Type: Waiver
  • Lab Director: THAMPI K. JOHN MD
  • NPI Number: 1538403670
  • Taxonomy: 261QA1903X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 05D1077958
LAB Type Ambulatory Surgery Center
Facility Name HERNDON SURGERY CENTER
Street 1843 E FIR AVE STE 104
City FRESNO
State CA
ZIP 93720
Phone 559 323-6611
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 12/21/2023
Certificate Expiration Date 12/20/2025
Facility Type Ambulatory Surgery Center
Lab Director THAMPI K. JOHN MD

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