1. Home
  2. Directory
  3. California
  4. Playa Vista
  5. Clinic Center
  6. NPI Profile

LAX SURGERY CENTER LLC
NPI 1457943243
Clinic/Center - Ambulatory Surgical in Playa Vista, CA

Active since February 03, 2021CLIA 05D2185535 · Waiver
5450 LINCOLN BLVD # 100, PLAYA VISTA, CA 90094(310) 305-9200 Get Directions Write a Review

NPPES record last updated: February 3, 2021. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Lax Surgery Center Llc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

LAX SURGERY CENTER LLC (NPI 1457943243) is a healthcare organization registered as an ambulatory surgical in Playa Vista, California and active in the NPI registry since February 2021. The organization holds a CLIA Waiver certificate valid through June 3, 2028 and lists Samson Yirgu, Administrator, as its authorized official.

NPPES Registry Identity

NPI1457943243
Entity TypeOrganization
Primary Taxonomy261QA1903X
Legal Business NameLAX SURGERY CENTER LLC
Location Address5450 LINCOLN BLVD # 100Playa Vista, CA 90094-2002
Mailing Address4712 Admiralty Way # 574Marina Del Rey, CA 90292-6905 · (310) 305-9200
Phone(310) 305-9200
Organization SubpartNo
Authorized OfficialSamson YirguAdministrator · (323) 500-7809
Enumeration DateFebruary 3, 2021
NPPES CertifiedFebruary 3, 2021
✔ NPI 1457943243 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyClinic/Center · Ambulatory SurgicalAmbulatory Health Care Facilities
Taxonomy Code261QA1903X
5450 LINCOLN BLVD # 100, Playa Vista, CA 90094
Open in Google Maps ↗

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 05D2185535

Lax Surgery Center LLC · Playa Vista, CA
Active · expires Jun 3, 2028
CLIA Number05D2185535
Laboratory TypeAmbulatory Surgery Center
Certificate Effective DateJune 4, 2026
Certificate Expiration DateJune 3, 2028
Laboratory DirectorAdnan Qureshi
Laboratory Phone(310) 305-9200
Laboratory LocationLax Surgery Center LLC5450 Lincoln Blvd Suite 100, Playa Vista, CA 90094
CLIA data matches this NPI record on: Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Lax Surgery Center LLC's NPI number?

The NPI number for Lax Surgery Center LLC is 1457943243. It was assigned to this organization in the NPPES registry on February 3, 2021.

Where is Lax Surgery Center LLC located?

Lax Surgery Center LLC is located at 5450 Lincoln Blvd # 100, Playa Vista, CA 90094. The listed phone number is (310) 305-9200.

What is Lax Surgery Center LLC's specialty?

The primary specialty registered for this NPI is Clinic/Center, specializing in Ambulatory Surgical, with taxonomy code 261QA1903X.

Does Lax Surgery Center LLC hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 05D2185535) is associated with this NPI, valid through June 3, 2028. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Lax Surgery Center LLC was last updated on February 3, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.