05D2314453 CLIA NUMBER - GENESIS AMBULATORY SURGERY CENTER, INC

Laboratory Demographics

  • CLIA Code: 05D2314453
  • Facility Name: GENESIS AMBULATORY SURGERY CENTER, INC
  • Facility Address: 1401 N TUSTIN AVE STE 105
    SANTA ANA, CA
    ZIP 92705
  • Facility Phone: 949 837-3000
  • Facility Type: Ambulatory Surgery Center
  • Facility Type: Waiver
  • Lab Director: YASSER H. SALEM
  • NPI Number: 1114707601
  • Taxonomy: 261QA1903X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 05D2314453
LAB Type Ambulatory Surgery Center
Facility Name GENESIS AMBULATORY SURGERY CENTER, INC
Street 1401 N TUSTIN AVE STE 105
City SANTA ANA
State CA
ZIP 92705
Phone 949 837-3000
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 11/20/2024
Certificate Expiration Date 11/19/2026
Facility Type Ambulatory Surgery Center
Lab Director YASSER H. SALEM

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