05D2062405 CLIA NUMBER - CHILDRENS WALNUT CREEK OUTPATIENT SURGERY

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Laboratory Demographics

CLIA Number: 05D2062405

Facility Name: CHILDRENS WALNUT CREEK OUTPATIENT SURGERY

Facility Address:
2401 SHADELANDS DR
WALNUT CREEK, CA
ZIP 94598
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Facility Phone Number: 510 428-3885

Facility Type: Ambulatory Surgery Center

Certificate Type: Accreditation

NPI Number: 1245430016

Taxonomy: 261QM0855X - Clinic/Center
An entity, facility, or distinct part of a facility providing diagnostic, treatment, and prescriptive services related to mental and behavioral disorders in children and adolescents. Services may be provided to parents and family members of the patient in the form of conjoint, group, or individual therapy, and education and/or training.

CLIA Record

Field Name	Field Value
CLIA Number	05D2062405
LAB Type	Ambulatory Surgery Center
Facility Name	CHILDRENS WALNUT CREEK OUTPATIENT SURGERY
Street	2401 SHADELANDS DR
City	WALNUT CREEK
State	CA
ZIP	94598
Phone	510 428-3885
CertificateType	1
CertificateEffectiveDate	5/5/2024
CertificateExpirationDate	5/4/2026
FacilityType	Accreditation

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This page was last updated on: 4/23/2024