05D2059512 CLIA NUMBER - RENAISSANCE ASC, LLC

Laboratory Demographics

  • CLIA Code: 05D2059512
  • Facility Name: RENAISSANCE ASC, LLC
  • Facility Address: 44139 MONTEREY STE B
    PALM DESERT, CA
    ZIP 92260
  • Facility Phone: 760 773-4411
  • Facility Type: Ambulatory Surgery Center
  • Facility Type: Waiver
  • Lab Director: MICHAEL SAMUEL
  • NPI Number: 1295072049
  • Taxonomy: 261QA1903X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 05D2059512
LAB Type Ambulatory Surgery Center
Facility Name RENAISSANCE ASC, LLC
Street 44139 MONTEREY STE B
City PALM DESERT
State CA
ZIP 92260
Phone 760 773-4411
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 5/23/2025
Certificate Expiration Date 5/22/2027
Facility Type Ambulatory Surgery Center
Lab Director MICHAEL SAMUEL

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