05D2074177 CLIA NUMBER - ACE ENDOSCOPY AND SURGERY CENTER

Laboratory Demographics

  • CLIA Code: 05D2074177
  • Facility Name: ACE ENDOSCOPY AND SURGERY CENTER
  • Facility Address: 2006 N RIVERSIDE AVE
    RIALTO, CA
    ZIP 92376
  • Facility Phone: 909 881-3032
  • Facility Type: Ambulatory Surgery Center
  • Facility Type: Waiver
  • Lab Director: KUMARAVELU BALASUBRAMANIAN, MD
  • NPI Number: 1881015584
  • Taxonomy: 261QA1903X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 05D2074177
LAB Type Ambulatory Surgery Center
Facility Name ACE ENDOSCOPY AND SURGERY CENTER
Street 2006 N RIVERSIDE AVE
City RIALTO
State CA
ZIP 92376
Phone 909 881-3032
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 3/3/2024
Certificate Expiration Date 3/2/2026
Facility Type Ambulatory Surgery Center
Lab Director KUMARAVELU BALASUBRAMANIAN, MD

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This page was last updated on: 6/4/2025