05D2087077 CLIA NUMBER - PLACENTIA SURGERY CENTER

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Laboratory Demographics

CLIA Number: 05D2087077

Facility Name: PLACENTIA SURGERY CENTER

Facility Address:
1041 E YORBA LINDA BLVD STE 200A
PLACENTIA, CA
ZIP 92870
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Facility Phone Number: 714 223-9000

Facility Type: Ambulatory Surgery Center

Certificate Type: Waiver

NPI Number: 1760803233

Taxonomy: 261QA1903X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	05D2087077
LAB Type	Ambulatory Surgery Center
Facility Name	PLACENTIA SURGERY CENTER
Street	1041 E YORBA LINDA BLVD STE 200A
City	PLACENTIA
State	CA
ZIP	92870
Phone	714 223-9000
CertificateType	4
CertificateEffectiveDate	11/17/2022
CertificateExpirationDate	11/16/2024
FacilityType	Waiver

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