05D2118541 CLIA NUMBER - CENTURION SURGICAL CENTER, INC.

Laboratory Demographics

CLIA Number: 05D2118541

Facility Name: CENTURION SURGICAL CENTER, INC.

Facility Address:
30200 AGOURA RD STE 160
AGOURA HILLS, CA
ZIP 91301
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Facility Phone Number: 818 597-1278

Facility Type: Ambulatory Surgery Center

Certificate Type: Waiver

NPI Number: 1801346309

Taxonomy: 261QA1903X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	05D2118541
LAB Type	Ambulatory Surgery Center
Facility Name	CENTURION SURGICAL CENTER, INC.
Street	30200 AGOURA RD STE 160
City	AGOURA HILLS
State	CA
ZIP	91301
Phone	818 597-1278
CertificateType	4
CertificateEffectiveDate	5/23/2023
CertificateExpirationDate	5/22/2025
FacilityType	Waiver

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