05D2146124 CLIA NUMBER - ANTELOPE VALLEY SPECIALTY SURGICAL CENTER LLC

Laboratory Demographics

CLIA Number: 05D2146124

Facility Name: ANTELOPE VALLEY SPECIALTY SURGICAL CENTER LLC

Facility Address:
655 W AVENUE Q
PALMDALE, CA
ZIP 93551
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Facility Phone Number: (818) 348-7246

Facility Type: AMBULATORY SURGERY CENTER

Certificate Type: Waiver

NPI Number: 1780108951

Taxonomy: 261QA1903X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	05D2146124
LAB Type	AMBULATORY SURGERY CENTER
Facility Name	ANTELOPE VALLEY SPECIALTY SURGICAL CENTER LLC
Street	655 W AVENUE Q
City	PALMDALE
State	CA
ZIP	93551
Phone	(818) 348-7246

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This page was last updated on: 5/11/2023