05D2098776 CLIA NUMBER - INNOVATIVE SURGERY CENTER LLC

Laboratory Demographics

  • CLIA Code: 05D2098776
  • Facility Name: INNOVATIVE SURGERY CENTER LLC
  • Facility Address: 6610 FLANDERS DR STE 100
    SAN DIEGO, CA
    ZIP 92121
  • Facility Phone: 858 869-4433
  • Facility Type: Ambulatory Surgery Center
  • Facility Type: Waiver
  • Lab Director: KHANG T. NGUYEN
  • NPI Number: 1528239761
  • Taxonomy: 208200000X - Plastic Surgery

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CLIA Record

Field Name Field Value
CLIA Number 05D2098776
LAB Type Ambulatory Surgery Center
Facility Name INNOVATIVE SURGERY CENTER LLC
Street 6610 FLANDERS DR STE 100
City SAN DIEGO
State CA
ZIP 92121
Phone 858 869-4433
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 7/14/2025
Certificate Expiration Date 7/13/2027
Facility Type Ambulatory Surgery Center
Lab Director KHANG T. NGUYEN

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