05D2284909 CLIA NUMBER - AVALON SURGERY AND ROBOTIC CENTER

Laboratory Demographics

CLIA Number: 05D2284909

Facility Name: AVALON SURGERY AND ROBOTIC CENTER

Facility Address:
435 ARDEN AVE SUITE 520
GLENDALE, CA
ZIP 91203
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Facility Phone Number: 818 696-0091

Facility Type: Ambulatory Surgery Center

Certificate Type: Waiver

NPI Number: 1194185637

Taxonomy: 261QA1903X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	05D2284909
LAB Type	Ambulatory Surgery Center
Facility Name	AVALON SURGERY AND ROBOTIC CENTER
Street	435 ARDEN AVE SUITE 520
City	GLENDALE
State	CA
ZIP	91203
Phone	818 696-0091
CertificateType	4
CertificateEffectiveDate	6/29/2023
CertificateExpirationDate	6/28/2025
FacilityType	Waiver

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