05D2113086 CLIA NUMBER - ORANGE ASC, LLC

Laboratory Demographics

  • CLIA Code: 05D2113086
  • Facility Name: ORANGE ASC, LLC
  • Facility Address: 1403 N TUSTIN AVE, SUITE 100
    SANTA ANA, CA
    ZIP 92705
  • Facility Phone: 714 633-1338
  • Facility Type: Ambulatory Surgery Center
  • Facility Type: Waiver
  • Lab Director: DR. JESSICA BOECKMANN
  • NPI Number: 1780059014
  • Taxonomy: 261QA1903X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 05D2113086
LAB Type Ambulatory Surgery Center
Facility Name ORANGE ASC, LLC
Street 1403 N TUSTIN AVE, SUITE 100
City SANTA ANA
State CA
ZIP 92705
Phone 714 633-1338
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 5/16/2024
Certificate Expiration Date 5/15/2026
Facility Type Ambulatory Surgery Center
Lab Director DR. JESSICA BOECKMANN

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