05D2057821 CLIA NUMBER - Skin Surgery Center

Laboratory Demographics

CLIA Number: 05D2057821

Facility Name: Skin Surgery Center

Facility Address:
267 W. Hillcrest Drive Ste 1,
Thousand Oaks, CA
ZIP 91360
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Facility Phone Number: (805) 497-1694

Facility Type: AMBULATORY SURGERY CENTER

Certificate Type: Waiver

NPI Number: 1740470053

Taxonomy: 261QA1903X - Clinic/Center

CLIA Record

Field Name Field Value
CLIA Number 05D2057821
LAB Type AMBULATORY SURGERY CENTER
Facility Name Skin Surgery Center
Street 267 W. Hillcrest Drive Ste 1,
City Thousand Oaks
State CA
ZIP 91360
Phone 8054971694

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This page was last updated on: 5/19/2019