05D2035289 CLIA NUMBER - PLASTIC & RECONSTRUCTIVE SURGERY CTR

Laboratory Demographics

  • CLIA Code: 05D2035289
  • Facility Name: PLASTIC & RECONSTRUCTIVE SURGERY CTR
  • Facility Address: 1387 SANTA RITA ROAD
    PLEASANTON, CA
    ZIP 94566
  • Facility Phone: 925 462-3700
  • Facility Type: Ambulatory Surgery Center
  • Facility Type: Waiver
  • Lab Director: ERIC P. BACHELOR
  • NPI Number: 1043249972
  • Taxonomy: 261QA1903X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 05D2035289
LAB Type Ambulatory Surgery Center
Facility Name PLASTIC & RECONSTRUCTIVE SURGERY CTR
Street 1387 SANTA RITA ROAD
City PLEASANTON
State CA
ZIP 94566
Phone 925 462-3700
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 1/13/2024
Certificate Expiration Date 1/12/2026
Facility Type Ambulatory Surgery Center
Lab Director ERIC P. BACHELOR

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