05D2148980 CLIA NUMBER - PACIFIC CARE SURGERY CENTER

Laboratory Demographics

  • CLIA Code: 05D2148980
  • Facility Name: PACIFIC CARE SURGERY CENTER
  • Facility Address: 1304 15TH STREET STE 403
    SANTA MONICA, CA
    ZIP 90404
  • Facility Phone: 310 453-6500
  • Facility Type: Ambulatory Surgery Center
  • Facility Type: Waiver
  • Lab Director: PAYAM DANESHRAD, MD
  • NPI Number: 1902329899
  • Taxonomy: 261QA1903X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 05D2148980
LAB Type Ambulatory Surgery Center
Facility Name PACIFIC CARE SURGERY CENTER
Street 1304 15TH STREET STE 403
City SANTA MONICA
State CA
ZIP 90404
Phone 310 453-6500
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 5/22/2024
Certificate Expiration Date 5/21/2026
Facility Type Ambulatory Surgery Center
Lab Director PAYAM DANESHRAD, MD

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