05D1086549 CLIA NUMBER - TRACY OUTPATIENT SURGERY CENTER

Laboratory Demographics

  • CLIA Code: 05D1086549
  • Facility Name: TRACY OUTPATIENT SURGERY CENTER
  • Facility Address: 530 W EATON AVENUE, SUITE P
    TRACY, CA
    ZIP 95376
  • Facility Phone: 209 833-8797
  • Facility Type: Ambulatory Surgery Center
  • Facility Type: Waiver
  • Lab Director: HARPREET GREWAL, MD
  • NPI Number: 1720044605
  • Taxonomy: 261QE0800X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 05D1086549
LAB Type Ambulatory Surgery Center
Facility Name TRACY OUTPATIENT SURGERY CENTER
Street 530 W EATON AVENUE, SUITE P
City TRACY
State CA
ZIP 95376
Phone 209 833-8797
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 7/15/2024
Certificate Expiration Date 7/14/2026
Facility Type Ambulatory Surgery Center
Lab Director HARPREET GREWAL, MD

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