05D2084643 CLIA NUMBER - SEA SURGERY CENTER, LLC

Laboratory Demographics

  • CLIA Code: 05D2084643
  • Facility Name: SEA SURGERY CENTER, LLC
  • Facility Address: 770 PACIFIC COAST HWY # 102
    SEAL BEACH, CA
    ZIP 90740
  • Facility Phone: 562 352-8396
  • Facility Type: Ambulatory Surgery Center
  • Facility Type: Waiver
  • Lab Director: JACK SHOHET, MD
  • NPI Number: 1750712667
  • Taxonomy: 261QA1903X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 05D2084643
LAB Type Ambulatory Surgery Center
Facility Name SEA SURGERY CENTER, LLC
Street 770 PACIFIC COAST HWY # 102
City SEAL BEACH
State CA
ZIP 90740
Phone 562 352-8396
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 9/26/2024
Certificate Expiration Date 9/25/2026
Facility Type Ambulatory Surgery Center
Lab Director JACK SHOHET, MD

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