05D2152734 CLIA NUMBER - SHORELINE SURGERY CENTER LLC

Laboratory Demographics

  • CLIA Code: 05D2152734
  • Facility Name: SHORELINE SURGERY CENTER LLC
  • Facility Address: 4300 LONG BEACH BLVD STE 150
    LONG BEACH, CA
    ZIP 90807
  • Facility Phone: 562 222-8764
  • Facility Type: Ambulatory Surgery Center
  • Facility Type: Waiver
  • Lab Director: ESSAM TAYMOUR
  • NPI Number: 1386134062
  • Taxonomy: 208600000X - Surgery

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CLIA Record

Field Name Field Value
CLIA Number 05D2152734
LAB Type Ambulatory Surgery Center
Facility Name SHORELINE SURGERY CENTER LLC
Street 4300 LONG BEACH BLVD STE 150
City LONG BEACH
State CA
ZIP 90807
Phone 562 222-8764
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 8/16/2024
Certificate Expiration Date 8/15/2026
Facility Type Ambulatory Surgery Center
Lab Director ESSAM TAYMOUR

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