10D2070076 CLIA NUMBER - RIVERSIDE KINGSLEY ENDOSCOPY SURGICENTER LLCDBA RIVERSIDE ENDOSCOPY CENTER

Laboratory Demographics

  • CLIA Code: 10D2070076
  • Facility Name: RIVERSIDE KINGSLEY ENDOSCOPY SURGICENTER LLCDBA RIVERSIDE ENDOSCOPY CENTER
  • Facility Address: 2151 RIVERSIDE AVENUE SUITE 1
    JACKSONVILLE, FL
    ZIP 32204
  • Facility Phone: 904 388-8686
  • Facility Type: Ambulatory Surgery Center
  • Facility Type: Waiver
  • Lab Director: ABDI ABBASSI
  • NPI Number: 1619213303
  • Taxonomy: 261QA1903X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 10D2070076
LAB Type Ambulatory Surgery Center
Facility Name RIVERSIDE KINGSLEY ENDOSCOPY SURGICENTER LLCDBA RIVERSIDE ENDOSCOPY CENTER
Street 2151 RIVERSIDE AVENUE SUITE 1
City JACKSONVILLE
State FL
ZIP 32204
Phone 904 388-8686
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 12/10/2023
Certificate Expiration Date 12/9/2025
Facility Type Ambulatory Surgery Center
Lab Director ABDI ABBASSI

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