05D2155301 CLIA NUMBER - ASI SURGERY CENTER, INC

Laboratory Demographics

  • CLIA Code: 05D2155301
  • Facility Name: ASI SURGERY CENTER, INC
  • Facility Address: 4836 VAN NUYS BLVD. SUITE A
    SHERMAN OAKS, CA
    ZIP 91403
  • Facility Phone: 818 907-7546
  • Facility Type: Ambulatory Surgery Center
  • Facility Type: Waiver
  • Lab Director: ILYA REYTER
  • NPI Number: 1215286083
  • Taxonomy: 261QA1903X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 05D2155301
LAB Type Ambulatory Surgery Center
Facility Name ASI SURGERY CENTER, INC
Street 4836 VAN NUYS BLVD. SUITE A
City SHERMAN OAKS
State CA
ZIP 91403
Phone 818 907-7546
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 9/26/2024
Certificate Expiration Date 9/25/2026
Facility Type Ambulatory Surgery Center
Lab Director ILYA REYTER

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