05D2089586 CLIA NUMBER - ROLLING OAKS SURGERY CENTER

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Laboratory Demographics

CLIA Number: 05D2089586

Facility Name: ROLLING OAKS SURGERY CENTER

Facility Address:
415 E ROLLING OAKS DR STE 115
THOUSAND OAKS, CA
ZIP 91361
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Facility Phone Number: 805 373-7073

Facility Type: Ambulatory Surgery Center

Certificate Type: Waiver

NPI Number: 1003216276

Taxonomy: 261QA1903X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	05D2089586
LAB Type	Ambulatory Surgery Center
Facility Name	ROLLING OAKS SURGERY CENTER
Street	415 E ROLLING OAKS DR STE 115
City	THOUSAND OAKS
State	CA
ZIP	91361
Phone	805 373-7073
CertificateType	4
CertificateEffectiveDate	1/5/2023
CertificateExpirationDate	1/4/2025
FacilityType	Waiver

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