05D2275213 CLIA NUMBER - SANTA ROSA SURGICAL SERVICES LLC

Laboratory Demographics

  • CLIA Code: 05D2275213
  • Facility Name: SANTA ROSA SURGICAL SERVICES LLC
  • Facility Address: 1739 4TH ST
    SANTA ROSA, CA
    ZIP 95404
  • Facility Phone: 707 931-5599
  • Facility Type: Ambulatory Surgery Center
  • Facility Type: Waiver
  • Lab Director: JASON POPE
  • NPI Number: 1497407894
  • Taxonomy: 261QA1903X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 05D2275213
LAB Type Ambulatory Surgery Center
Facility Name SANTA ROSA SURGICAL SERVICES LLC
Street 1739 4TH ST
City SANTA ROSA
State CA
ZIP 95404
Phone 707 931-5599
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 1/18/2025
Certificate Expiration Date 1/17/2027
Facility Type Ambulatory Surgery Center
Lab Director JASON POPE

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