05D2074368 CLIA NUMBER - PHYSICIANS SURGERY CENTER AT GLENDALE ADVENTIST, LLC

Laboratory Demographics

  • CLIA Code: 05D2074368
  • Facility Name: PHYSICIANS SURGERY CENTER AT GLENDALE ADVENTIST, LLC
  • Facility Address: 1500 E. CHEVY CHASE DRIVE STE 101
    GLENDALE, CA
    ZIP 91206
  • Facility Phone: 818 863-4225
  • Facility Type: Ambulatory Surgery Center
  • Facility Type: Waiver
  • Lab Director: PHILIP O. MERRITT, MD
  • NPI Number: 1760807127
  • Taxonomy: 261QA1903X - Clinic/Center

Map and Directions

Get Directions

CLIA Record

Field Name Field Value
CLIA Number 05D2074368
LAB Type Ambulatory Surgery Center
Facility Name PHYSICIANS SURGERY CENTER AT GLENDALE ADVENTIST, LLC
Street 1500 E. CHEVY CHASE DRIVE STE 101
City GLENDALE
State CA
ZIP 91206
Phone 818 863-4225
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 3/7/2024
Certificate Expiration Date 3/6/2026
Facility Type Ambulatory Surgery Center
Lab Director PHILIP O. MERRITT, MD

Download Record

Download this CLIA record record in Text format: Export

Download this CLIA record record in Excel (CSV) format: Export

Download this CLIA record record in XML format: Export

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