05D2098127 CLIA NUMBER - WEBSTER OUTPATIENT SURGERY CENTER

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Laboratory Demographics

CLIA Number: 05D2098127

Facility Name: WEBSTER OUTPATIENT SURGERY CENTER

Facility Address:
200 PORTER DR STE 100
SAN RAMON, CA
ZIP 94583
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Facility Phone Number: 925 600-1900

Facility Type: Ambulatory Surgery Center

Certificate Type: Waiver

NPI Number: 1467999813

Taxonomy: 261QA1903X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	05D2098127
LAB Type	Ambulatory Surgery Center
Facility Name	WEBSTER OUTPATIENT SURGERY CENTER
Street	200 PORTER DR STE 100
City	SAN RAMON
State	CA
ZIP	94583
Phone	925 600-1900
CertificateType	4
CertificateEffectiveDate	6/30/2023
CertificateExpirationDate	6/29/2025
FacilityType	Waiver

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