05D2028923 CLIA NUMBER - BRAND TARZANA SURGICAL INSTITUTE

Home > CLIA Lookup > 05D2028923

Laboratory Demographics

CLIA Number: 05D2028923

Facility Name: BRAND TARZANA SURGICAL INSTITUTE

Facility Address:
19228 VENTURA BLVD, STE A
TARZANA, CA
ZIP 91356
Get Directions

Facility Phone Number: 818 578-5125

Facility Type: Ambulatory Surgery Center

Certificate Type: Waiver

NPI Number: 1538451760

Taxonomy: 261QA1903X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	05D2028923
LAB Type	Ambulatory Surgery Center
Facility Name	BRAND TARZANA SURGICAL INSTITUTE
Street	19228 VENTURA BLVD, STE A
City	TARZANA
State	CA
ZIP	91356
Phone	818 578-5125
CertificateType	4
CertificateEffectiveDate	8/26/2023
CertificateExpirationDate	8/25/2025
FacilityType	Waiver

Download Record

Export to text format icon Download this CLIA NUMBER record in Text format: Export

Export to text format icon Download this CLIA NUMBER record in Excel (CSV) format: Export

Export to text format icon Download this CLIA NUMBER record in XML format: Export

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