05D2285523 CLIA NUMBER - PRO HEALTH SURGERY CENTER

Laboratory Demographics

  • CLIA Code: 05D2285523
  • Facility Name: PRO HEALTH SURGERY CENTER
  • Facility Address: 16311 VENTURA BLVD SUITE 1010
    ENCINO, CA
    ZIP 91436
  • Facility Phone: 818 990-9080
  • Facility Type: Ambulatory Surgery Center
  • Facility Type: Waiver
  • Lab Director: KARAPET DERMENDJIAN
  • NPI Number: 1396480539
  • Taxonomy: 261QA1903X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 05D2285523
LAB Type Ambulatory Surgery Center
Facility Name PRO HEALTH SURGERY CENTER
Street 16311 VENTURA BLVD SUITE 1010
City ENCINO
State CA
ZIP 91436
Phone 818 990-9080
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 7/13/2025
Certificate Expiration Date 7/12/2027
Facility Type Ambulatory Surgery Center
Lab Director KARAPET DERMENDJIAN

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