05D2297533 CLIA NUMBER - VALLEY PLAZA SURGERY CENTER

Laboratory Demographics

  • CLIA Code: 05D2297533
  • Facility Name: VALLEY PLAZA SURGERY CENTER
  • Facility Address: 12134 VICTORY BLVD, STE E
    NORTH HOLLYWOOD, CA
    ZIP 91606
  • Facility Phone: 844 772-4752
  • Facility Type: Ambulatory Surgery Center
  • Facility Type: Waiver
  • Lab Director: ARCHIE MAYS
  • NPI Number: 1659157246
  • Taxonomy: 261QA1903X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 05D2297533
LAB Type Ambulatory Surgery Center
Facility Name VALLEY PLAZA SURGERY CENTER
Street 12134 VICTORY BLVD, STE E
City NORTH HOLLYWOOD
State CA
ZIP 91606
Phone 844 772-4752
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 1/17/2024
Certificate Expiration Date 1/16/2026
Facility Type Ambulatory Surgery Center
Lab Director ARCHIE MAYS

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