05D2111037 CLIA NUMBER - RIVERWALK SURGERY CENTER, LLC

Laboratory Demographics

  • CLIA Code: 05D2111037
  • Facility Name: RIVERWALK SURGERY CENTER, LLC
  • Facility Address: 4234 RIVERWALK PKWY STE 140
    RIVERSIDE, CA
    ZIP 92505
  • Facility Phone: 951 683-1166
  • Facility Type: Ambulatory Surgery Center
  • Facility Type: Waiver
  • Lab Director: JOSEPH KU, MD
  • NPI Number: 1922429109
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 05D2111037
LAB Type Ambulatory Surgery Center
Facility Name RIVERWALK SURGERY CENTER, LLC
Street 4234 RIVERWALK PKWY STE 140
City RIVERSIDE
State CA
ZIP 92505
Phone 951 683-1166
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 3/29/2024
Certificate Expiration Date 3/28/2026
Facility Type Ambulatory Surgery Center
Lab Director JOSEPH KU, MD

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