05D2051707 CLIA NUMBER - CAPITOLA SURGERY CENTER

Laboratory Demographics

  • CLIA Code: 05D2051707
  • Facility Name: CAPITOLA SURGERY CENTER
  • Facility Address: 2265 41ST AVE
    CAPITOLA, CA
    ZIP 95010
  • Facility Phone: 831 372-2169
  • Facility Type: Ambulatory Surgery Center
  • Facility Type: Waiver
  • Lab Director: VICTOR LI
  • NPI Number: 1407116361
  • Taxonomy: 261QA1903X - Clinic/Center

Map and Directions

Get Directions

CLIA Record

Field Name Field Value
CLIA Number 05D2051707
LAB Type Ambulatory Surgery Center
Facility Name CAPITOLA SURGERY CENTER
Street 2265 41ST AVE
City CAPITOLA
State CA
ZIP 95010
Phone 831 372-2169
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 12/26/2024
Certificate Expiration Date 12/25/2026
Facility Type Ambulatory Surgery Center
Lab Director VICTOR LI

Download Record

Download this CLIA record record in Text format: Export

Download this CLIA record record in Excel (CSV) format: Export

Download this CLIA record record in XML format: Export

This page was last updated on: 6/4/2025