05D2158789 CLIA NUMBER - SANDHU SURGERY CENTER, LLC

Laboratory Demographics

CLIA Number: 05D2158789

Facility Name: SANDHU SURGERY CENTER, LLC

Facility Address:
41324 12TH STREET SUITE C
PALMDALE, CA
ZIP 93551
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Facility Phone Number: 661 945-0818

Facility Type: Ambulatory Surgery Center

Certificate Type: Waiver

NPI Number: 1699274464

Taxonomy: 261QA1903X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	05D2158789
LAB Type	Ambulatory Surgery Center
Facility Name	SANDHU SURGERY CENTER, LLC
Street	41324 12TH STREET SUITE C
City	PALMDALE
State	CA
ZIP	93551
Phone	661 945-0818
CertificateType	4
CertificateEffectiveDate	12/6/2022
CertificateExpirationDate	12/5/2024
FacilityType	Waiver

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This page was last updated on: 4/23/2024