05D2316209 CLIA NUMBER - SACRAMENTO PREMIER SURGERY CENTER LLC

Laboratory Demographics

  • CLIA Code: 05D2316209
  • Facility Name: SACRAMENTO PREMIER SURGERY CENTER LLC
  • Facility Address: 530 PLAZA DR STE 110
    FOLSOM, CA
    ZIP 95630
  • Facility Phone: 818 855-1507
  • Facility Type: Ambulatory Surgery Center
  • Facility Type: Waiver
  • Lab Director: ANDREW VARGAS
  • NPI Number: 1548085673
  • Taxonomy: 261QA1903X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 05D2316209
LAB Type Ambulatory Surgery Center
Facility Name SACRAMENTO PREMIER SURGERY CENTER LLC
Street 530 PLAZA DR STE 110
City FOLSOM
State CA
ZIP 95630
Phone 818 855-1507
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 12/30/2024
Certificate Expiration Date 12/29/2026
Facility Type Ambulatory Surgery Center
Lab Director ANDREW VARGAS

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