05D2118543 CLIA NUMBER - RIDGE SURGICAL CENTER, LLC

Laboratory Demographics

  • CLIA Code: 05D2118543
  • Facility Name: RIDGE SURGICAL CENTER, LLC
  • Facility Address: 30300 AGOURA RD STE B 160
    AGOURA HILLS, CA
    ZIP 91301
  • Facility Phone: 818 889-1858
  • Facility Type: Ambulatory Surgery Center
  • Facility Type: Waiver
  • Lab Director: ANTHONY A. VIRELLA, MD
  • NPI Number: 1194175117
  • Taxonomy: 261QA1903X - Clinic/Center

Map and Directions

Get Directions

CLIA Record

Field Name Field Value
CLIA Number 05D2118543
LAB Type Ambulatory Surgery Center
Facility Name RIDGE SURGICAL CENTER, LLC
Street 30300 AGOURA RD STE B 160
City AGOURA HILLS
State CA
ZIP 91301
Phone 818 889-1858
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 9/9/2024
Certificate Expiration Date 9/8/2026
Facility Type Ambulatory Surgery Center
Lab Director ANTHONY A. VIRELLA, MD

Download Record

Download this CLIA record record in Text format: Export

Download this CLIA record record in Excel (CSV) format: Export

Download this CLIA record record in XML format: Export

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