05D2180299 CLIA NUMBER - ELITE SURGERY CENTER, LLC

Laboratory Demographics

CLIA Number: 05D2180299

Facility Name: ELITE SURGERY CENTER, LLC

Facility Address:
38920 TRADE CENTER DRIVE
PALMDALE, CA
ZIP 93551
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Facility Phone Number: 818 441-3606

Facility Type: Ambulatory Surgery Center

Certificate Type: Waiver

NPI Number: 1396277208

Taxonomy: 261QA1903X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	05D2180299
LAB Type	Ambulatory Surgery Center
Facility Name	ELITE SURGERY CENTER, LLC
Street	38920 TRADE CENTER DRIVE
City	PALMDALE
State	CA
ZIP	93551
Phone	818 441-3606
CertificateType	4
CertificateEffectiveDate	3/11/2024
CertificateExpirationDate	3/10/2026
FacilityType	Waiver

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