04D2094452 CLIA NUMBER - INTERVENTIONAL SURGERY INSTITUTE

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Laboratory Demographics

CLIA Number: 04D2094452

Facility Name: INTERVENTIONAL SURGERY INSTITUTE

Facility Address:
#9 FREEWAY DRIVE
LITTLE ROCK, AR
ZIP 72204
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Facility Phone Number: 501 766-1065

Facility Type: Ambulatory Surgery Center

Certificate Type: Waiver

NPI Number: 1043625221

Taxonomy: 261QA1903X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	04D2094452
LAB Type	Ambulatory Surgery Center
Facility Name	INTERVENTIONAL SURGERY INSTITUTE
Street	#9 FREEWAY DRIVE
City	LITTLE ROCK
State	AR
ZIP	72204
Phone	501 766-1065
CertificateType	4
CertificateEffectiveDate	4/17/2023
CertificateExpirationDate	4/16/2025
FacilityType	Waiver

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This page was last updated on: 4/23/2024