10D0927556 CLIA NUMBER - RIVERWALK ASC LLC DBA RIVERWALK SURGERY CENTER

Laboratory Demographics

CLIA Number: 10D0927556

Facility Name: RIVERWALK ASC LLC DBA RIVERWALK SURGERY CENTER

Facility Address:
8350 RIVERWALK PARK BLVD STE 4
FORT MYERS, FL
ZIP 33919
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Facility Phone Number: 239 489-4909

Facility Type: Ambulatory Surgery Center

Certificate Type: Waiver

NPI Number: 1215025010

Taxonomy: 261QA1903X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	10D0927556
LAB Type	Ambulatory Surgery Center
Facility Name	RIVERWALK ASC LLC DBA RIVERWALK SURGERY CENTER
Street	8350 RIVERWALK PARK BLVD STE 4
City	FORT MYERS
State	FL
ZIP	33919
Phone	239 489-4909
CertificateType	4
CertificateEffectiveDate	4/23/2023
CertificateExpirationDate	4/22/2025
FacilityType	Waiver

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