05D2263089 CLIA NUMBER - ON BEACH SURGERY CENTER, LLC

Laboratory Demographics

  • CLIA Code: 05D2263089
  • Facility Name: ON BEACH SURGERY CENTER, LLC
  • Facility Address: 5832 BEACH BLVD, STE 210
    BUENA PARK, CA
    ZIP 90621
  • Facility Phone: 714 515-5300
  • Facility Type: Ambulatory Surgery Center
  • Facility Type: Waiver
  • Lab Director: PHILLIP LIM
  • NPI Number: 1003420001
  • Taxonomy: 261QA1903X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 05D2263089
LAB Type Ambulatory Surgery Center
Facility Name ON BEACH SURGERY CENTER, LLC
Street 5832 BEACH BLVD, STE 210
City BUENA PARK
State CA
ZIP 90621
Phone 714 515-5300
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 6/22/2024
Certificate Expiration Date 6/21/2026
Facility Type Ambulatory Surgery Center
Lab Director PHILLIP LIM

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