05D2240626 CLIA NUMBER - CARDIOVASCULAR INTERVENTIONAL SURGERY CENTER

Laboratory Demographics

  • CLIA Code: 05D2240626
  • Facility Name: CARDIOVASCULAR INTERVENTIONAL SURGERY CENTER
  • Facility Address: 2621 S BRISTOL # 108B
    SANTA ANA, CA
    ZIP 92704
  • Facility Phone: 714 754-1684
  • Facility Type: Ambulatory Surgery Center
  • Facility Type: Waiver
  • Lab Director: ANIL SHAH
  • NPI Number: 1982288049
  • Taxonomy: 207RI0011X - Internal Medicine

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CLIA Record

Field Name Field Value
CLIA Number 05D2240626
LAB Type Ambulatory Surgery Center
Facility Name CARDIOVASCULAR INTERVENTIONAL SURGERY CENTER
Street 2621 S BRISTOL # 108B
City SANTA ANA
State CA
ZIP 92704
Phone 714 754-1684
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 10/20/2023
Certificate Expiration Date 10/19/2025
Facility Type Ambulatory Surgery Center
Lab Director ANIL SHAH

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