05D2029186 CLIA NUMBER - CONCOURSE DIAGNOSTIC AND SURGERY CENTER, LLC

Laboratory Demographics

  • CLIA Code: 05D2029186
  • Facility Name: CONCOURSE DIAGNOSTIC AND SURGERY CENTER, LLC
  • Facility Address: 18575 EAST GALE AVE STE 198
    CITY OF INDUSTRY, CA
    ZIP 91748
  • Facility Phone: 626 965-3880
  • Facility Type: Ambulatory Surgery Center
  • Facility Type: Waiver
  • Lab Director: HENRY H. CHANG
  • NPI Number: 1932496908
  • Taxonomy: 261QA1903X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 05D2029186
LAB Type Ambulatory Surgery Center
Facility Name CONCOURSE DIAGNOSTIC AND SURGERY CENTER, LLC
Street 18575 EAST GALE AVE STE 198
City CITY OF INDUSTRY
State CA
ZIP 91748
Phone 626 965-3880
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 9/1/2025
Certificate Expiration Date 8/31/2027
Facility Type Ambulatory Surgery Center
Lab Director HENRY H. CHANG

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