05D2177318 CLIA NUMBER - OC SPECIALTY CARE SURGERY CENTER

Laboratory Demographics

CLIA Number: 05D2177318

Facility Name: OC SPECIALTY CARE SURGERY CENTER

Facility Address:
1200 WEST TUSTIN AVENUE SUITE 155
SANTA ANA, CA
ZIP 92705
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Facility Phone Number: 951 734-7246

Facility Type: Ambulatory Surgery Center

Certificate Type: Waiver

NPI Number: 1922563808

Taxonomy: 261QA1903X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	05D2177318
LAB Type	Ambulatory Surgery Center
Facility Name	OC SPECIALTY CARE SURGERY CENTER
Street	1200 WEST TUSTIN AVENUE SUITE 155
City	SANTA ANA
State	CA
ZIP	92705
Phone	951 734-7246
CertificateType	4
CertificateEffectiveDate	1/8/2024
CertificateExpirationDate	1/7/2026
FacilityType	Waiver

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