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Licensing and Certification Program

Applications for an Ambulatory Surgical Center

The following forms and documents are required for licensure.
In addition to the forms below, you are required to submit additional documents for a change of ownership.  These documents must be submitted with your completed application.  The required information and instructions are listed on the checklist contained in the Ambulatory Surgical Center Application Request Letter and Instructional Checklist (PDF) letter.

Ambulatory Surgical Center

Required Forms to be Licensed:

Contact Us:

Phone: (916) 552-8632


Staff will respond to your inquiry within 48 hours.

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