05D2012132 CLIA NUMBER - MID VALLEY SURGERY CENTER, LLC

Laboratory Demographics

  • CLIA Code: 05D2012132
  • Facility Name: MID VALLEY SURGERY CENTER, LLC
  • Facility Address: 4682 ONTARIO MILLS PARKWAY
    ONTARIO, CA
    ZIP 91764
  • Facility Phone: 909 204-3540
  • Facility Type: Ambulatory Surgery Center
  • Facility Type: Waiver
  • Lab Director: MARC E. LYNCH, DO
  • NPI Number: 1992022297
  • Taxonomy: 261QA1903X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 05D2012132
LAB Type Ambulatory Surgery Center
Facility Name MID VALLEY SURGERY CENTER, LLC
Street 4682 ONTARIO MILLS PARKWAY
City ONTARIO
State CA
ZIP 91764
Phone 909 204-3540
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 8/30/2024
Certificate Expiration Date 8/29/2026
Facility Type Ambulatory Surgery Center
Lab Director MARC E. LYNCH, DO

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