05D2211393 CLIA NUMBER - SURGERY CENTER OF OAKLAND, LP

Laboratory Demographics

CLIA Number: 05D2211393

Facility Name: SURGERY CENTER OF OAKLAND, LP

Facility Address:
80 GRAND AVENUE, SUITE M-1
OAKLAND, CA
ZIP 94612
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Facility Phone Number: 805 679-6736

Facility Type: Ambulatory Surgery Center

Certificate Type: Waiver

NPI Number: 1972114171

Taxonomy: 261QA1903X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	05D2211393
LAB Type	Ambulatory Surgery Center
Facility Name	SURGERY CENTER OF OAKLAND, LP
Street	80 GRAND AVENUE, SUITE M-1
City	OAKLAND
State	CA
ZIP	94612
Phone	805 679-6736
CertificateType	4
CertificateEffectiveDate	1/27/2023
CertificateExpirationDate	1/26/2025
FacilityType	Waiver

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