05D2015970 CLIA NUMBER - ATLANTIC SURGICAL CENTER, LLC

Laboratory Demographics

  • CLIA Code: 05D2015970
  • Facility Name: ATLANTIC SURGICAL CENTER, LLC
  • Facility Address: 850 S ATLANTIC BLVD STE 104
    MONTEREY PARK, CA
    ZIP 91754
  • Facility Phone: 323 521-5215
  • Facility Type: Ambulatory Surgery Center
  • Facility Type: Waiver
  • Lab Director: TALAAL MAXIMOUS
  • NPI Number: 1851967053
  • Taxonomy: 251G00000X - Hospice Care, Community Based

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CLIA Record

Field Name Field Value
CLIA Number 05D2015970
LAB Type Ambulatory Surgery Center
Facility Name ATLANTIC SURGICAL CENTER, LLC
Street 850 S ATLANTIC BLVD STE 104
City MONTEREY PARK
State CA
ZIP 91754
Phone 323 521-5215
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 11/9/2024
Certificate Expiration Date 11/8/2026
Facility Type Ambulatory Surgery Center
Lab Director TALAAL MAXIMOUS

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