05D2304318 CLIA NUMBER - EVOLVE SURGERY CENTER

Laboratory Demographics

  • CLIA Code: 05D2304318
  • Facility Name: EVOLVE SURGERY CENTER
  • Facility Address: 23621 PARK SORRENTO STE 100
    CALABASAS, CA
    ZIP 91302
  • Facility Phone: 310 266-8921
  • Facility Type: Ambulatory Surgery Center
  • Facility Type: Waiver
  • Lab Director: RYAN MATTIE
  • NPI Number: 1083467286
  • Taxonomy: 261QA1903X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 05D2304318
LAB Type Ambulatory Surgery Center
Facility Name EVOLVE SURGERY CENTER
Street 23621 PARK SORRENTO STE 100
City CALABASAS
State CA
ZIP 91302
Phone 310 266-8921
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 5/10/2024
Certificate Expiration Date 5/9/2026
Facility Type Ambulatory Surgery Center
Lab Director RYAN MATTIE

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