05D2057515 CLIA NUMBER - PLAYA ADVANCE SURGICAL INSTITUTE, LLC

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Laboratory Demographics

CLIA Number: 05D2057515

Facility Name: PLAYA ADVANCE SURGICAL INSTITUTE, LLC

Facility Address:
5450 LINCOLN BLVD.
PLAYA VISTA, CA
ZIP 90094
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Facility Phone Number: (310) 301-5980

Facility Type: AMBULATORY SURGERY CENTER

Certificate Type: Waiver

NPI Number: 1659624682

Taxonomy: 261QA1903X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	05D2057515
LAB Type	AMBULATORY SURGERY CENTER
Facility Name	PLAYA ADVANCE SURGICAL INSTITUTE, LLC
Street	5450 LINCOLN BLVD.
City	PLAYA VISTA
State	CA
ZIP	90094
Phone	(310) 301-5980

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This page was last updated on: 5/11/2023