05D2083685 CLIA NUMBER - PHYSICIANS CHOICE SURGICENTER

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Laboratory Demographics

CLIA Number: 05D2083685

Facility Name: PHYSICIANS CHOICE SURGICENTER

Facility Address:
8342 GARDEN GROVE BOULEVARD #10
GARDEN GROVE, CA
ZIP 92844
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Facility Phone Number: 909 860-8612

Facility Type: Ambulatory Surgery Center

Certificate Type: Waiver

NPI Number: 1790190312

Taxonomy: 261QA1903X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	05D2083685
LAB Type	Ambulatory Surgery Center
Facility Name	PHYSICIANS CHOICE SURGICENTER
Street	8342 GARDEN GROVE BOULEVARD #10
City	GARDEN GROVE
State	CA
ZIP	92844
Phone	909 860-8612
CertificateType	4
CertificateEffectiveDate	9/10/2022
CertificateExpirationDate	9/9/2024
FacilityType	Waiver

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