05D2024726 CLIA NUMBER - ANTELOPE VALLEY SURGERY CENTER, PC

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Laboratory Demographics

CLIA Number: 05D2024726

Facility Name: ANTELOPE VALLEY SURGERY CENTER, PC

Facility Address:
631 W. AVENUE Q, SUITE C
PALMDALE, CA
ZIP 93551
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Facility Phone Number: 661 947-4600

Facility Type: Ambulatory Surgery Center

Certificate Type: Waiver

NPI Number: 1790198299

Taxonomy: 207Q00000X - Family Medicine
Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.

CLIA Record

Field Name	Field Value
CLIA Number	05D2024726
LAB Type	Ambulatory Surgery Center
Facility Name	ANTELOPE VALLEY SURGERY CENTER, PC
Street	631 W. AVENUE Q, SUITE C
City	PALMDALE
State	CA
ZIP	93551
Phone	661 947-4600
CertificateType	4
CertificateEffectiveDate	5/23/2023
CertificateExpirationDate	5/22/2025
FacilityType	Waiver

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This page was last updated on: 4/23/2024