05D2165351 CLIA NUMBER - PACIFIC RITZ SURGERY CENTER, LLC

Laboratory Demographics

  • CLIA Code: 05D2165351
  • Facility Name: PACIFIC RITZ SURGERY CENTER, LLC
  • Facility Address: 16311 VENTURA BOULEVARD, # 570
    ENCINO, CA
    ZIP 91436
  • Facility Phone: 818 827-5100
  • Facility Type: Ambulatory Surgery Center
  • Facility Type: Waiver
  • Lab Director: JEFFREY B. GLASER
  • NPI Number: 1518423672
  • Taxonomy: 261QA1903X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 05D2165351
LAB Type Ambulatory Surgery Center
Facility Name PACIFIC RITZ SURGERY CENTER, LLC
Street 16311 VENTURA BOULEVARD, # 570
City ENCINO
State CA
ZIP 91436
Phone 818 827-5100
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 4/25/2025
Certificate Expiration Date 4/24/2027
Facility Type Ambulatory Surgery Center
Lab Director JEFFREY B. GLASER

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