05D2221466 CLIA NUMBER - SEVEN OAKS SURGERY CENTER LLC

Laboratory Demographics

CLIA Number: 05D2221466

Facility Name: SEVEN OAKS SURGERY CENTER LLC

Facility Address:
401 E. HIGHLAND AVE, OUTPATIENT CENTER, 2ND FLOO
SAN BERNARDINO, CA
ZIP 92404
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Facility Phone Number: 909 751-2640

Facility Type: Ambulatory Surgery Center

Certificate Type: Waiver

NPI Number: 1891301065

Taxonomy: 261QA1903X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	05D2221466
LAB Type	Ambulatory Surgery Center
Facility Name	SEVEN OAKS SURGERY CENTER LLC
Street	401 E. HIGHLAND AVE, OUTPATIENT CENTER, 2ND FLOO
City	SAN BERNARDINO
State	CA
ZIP	92404
Phone	909 751-2640
CertificateType	4
CertificateEffectiveDate	4/21/2023
CertificateExpirationDate	4/20/2025
FacilityType	Waiver

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