05D2289814 CLIA NUMBER - HEART OF SAN DIEGO SURGICAL CENTER

Laboratory Demographics

CLIA Number: 05D2289814

Facility Name: HEART OF SAN DIEGO SURGICAL CENTER

Facility Address:
8705 COMPLEX DRIVE
SAN DIEGO, CA
ZIP 92123
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Facility Phone Number: 925 787-6700

Facility Type: Ambulatory Surgery Center

Certificate Type: Waiver

NPI Number: 1407592983

Taxonomy: 261QA1903X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	05D2289814
LAB Type	Ambulatory Surgery Center
Facility Name	HEART OF SAN DIEGO SURGICAL CENTER
Street	8705 COMPLEX DRIVE
City	SAN DIEGO
State	CA
ZIP	92123
Phone	925 787-6700
CertificateType	4
CertificateEffectiveDate	9/15/2023
CertificateExpirationDate	9/14/2025
FacilityType	Waiver

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