05D2165367 CLIA NUMBER - EMBASSY SURGERY CENTER LLC

Laboratory Demographics

  • CLIA Code: 05D2165367
  • Facility Name: EMBASSY SURGERY CENTER LLC
  • Facility Address: 42135 10TH STREET SUITE 325
    LANCASTER, CA
    ZIP 93534
  • Facility Phone: 661 237-5454
  • Facility Type: Ambulatory Surgery Center
  • Facility Type: Waiver
  • Lab Director: THOMAS NASSER
  • NPI Number: 1174063788
  • Taxonomy: 261QA1903X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 05D2165367
LAB Type Ambulatory Surgery Center
Facility Name EMBASSY SURGERY CENTER LLC
Street 42135 10TH STREET SUITE 325
City LANCASTER
State CA
ZIP 93534
Phone 661 237-5454
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 THOMAS NASSER

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