05D2092586 CLIA NUMBER - BEDFORD AMBULATORY SURGERY CENTER

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Laboratory Demographics

CLIA Number: 05D2092586

Facility Name: BEDFORD AMBULATORY SURGERY CENTER

Facility Address:
436 N. BEDFORD DR STE 215
BEVERLY HILLS, CA
ZIP 90210
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Facility Phone Number: 310 247-1932

Facility Type: Ambulatory Surgery Center

Certificate Type: Waiver

NPI Number: 1356494512

Taxonomy: 261QA1903X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	05D2092586
LAB Type	Ambulatory Surgery Center
Facility Name	BEDFORD AMBULATORY SURGERY CENTER
Street	436 N. BEDFORD DR STE 215
City	BEVERLY HILLS
State	CA
ZIP	90210
Phone	310 247-1932
CertificateType	4
CertificateEffectiveDate	3/9/2023
CertificateExpirationDate	3/8/2025
FacilityType	Waiver

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