13D2112987 CLIA NUMBER - RIVER CITY SURGICAL CENTER

Laboratory Demographics

  • CLIA Code: 13D2112987
  • Facility Name: RIVER CITY SURGICAL CENTER
  • Facility Address: 10118 W OVERLAND RD
    BOISE, ID
    ZIP 83709
  • Facility Phone: 208 384-9022
  • Facility Type: Ambulatory Surgery Center
  • Facility Type: Waiver
  • Lab Director: ROY H. ROGERS
  • NPI Number: 1558733147
  • Taxonomy: 261QA1903X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 13D2112987
LAB Type Ambulatory Surgery Center
Facility Name RIVER CITY SURGICAL CENTER
Street 10118 W OVERLAND RD
City BOISE
State ID
ZIP 83709
Phone 208 384-9022
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 5/12/2024
Certificate Expiration Date 5/11/2026
Facility Type Ambulatory Surgery Center
Lab Director ROY H. ROGERS

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