05D2065683 CLIA NUMBER - ADVANCED SURGICAL GROUP

Laboratory Demographics

  • CLIA Code: 05D2065683
  • Facility Name: ADVANCED SURGICAL GROUP
  • Facility Address: 2160 SUNSET BLVD STE 502
    ROCKLIN, CA
    ZIP 95765
  • Facility Phone: 888 543-2243
  • Facility Type: Ambulatory Surgery Center
  • Facility Type: Waiver
  • Lab Director: KAYVAN D. HADDADAN
  • NPI Number: 1073908604
  • Taxonomy: 261QA1903X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 05D2065683
LAB Type Ambulatory Surgery Center
Facility Name ADVANCED SURGICAL GROUP
Street 2160 SUNSET BLVD STE 502
City ROCKLIN
State CA
ZIP 95765
Phone 888 543-2243
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 9/12/2025
Certificate Expiration Date 9/11/2027
Facility Type Ambulatory Surgery Center
Lab Director KAYVAN D. HADDADAN

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