05D2291727 CLIA NUMBER - CLOVIS ENDOSCOPY ASC LLC DBA CLOVIS ENDOSCOPY CENTER

Laboratory Demographics

  • CLIA Code: 05D2291727
  • Facility Name: CLOVIS ENDOSCOPY ASC LLC DBA CLOVIS ENDOSCOPY CENTER
  • Facility Address: 501 NORTH MEDICAL CENTER SR EAST
    CLOVIS, CA
    ZIP 93611
  • Facility Phone: 559 448-8360
  • Facility Type: Ambulatory Surgery Center
  • Facility Type: Waiver
  • Lab Director: PRADNYA MITROO
  • NPI Number: 1164105599
  • Taxonomy: 261QA1903X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 05D2291727
LAB Type Ambulatory Surgery Center
Facility Name CLOVIS ENDOSCOPY ASC LLC DBA CLOVIS ENDOSCOPY CENTER
Street 501 NORTH MEDICAL CENTER SR EAST
City CLOVIS
State CA
ZIP 93611
Phone 559 448-8360
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 10/16/2025
Certificate Expiration Date 10/15/2027
Facility Type Ambulatory Surgery Center
Lab Director PRADNYA MITROO

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