19D1015204 CLIA NUMBER - RIVERPARK AMBULATORY SURGERY CENTER

Laboratory Demographics

  • CLIA Code: 19D1015204
  • Facility Name: RIVERPARK AMBULATORY SURGERY CENTER
  • Facility Address: 107 FRONT STREET
    VIDALIA, LA
    ZIP 71373
  • Facility Phone: 318 336-2218
  • Facility Type: Ambulatory Surgery Center
  • Facility Type: Waiver
  • Lab Director: KAREN MARTIN
  • NPI Number: 1144216847
  • Taxonomy: 261QA1903X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 19D1015204
LAB Type Ambulatory Surgery Center
Facility Name RIVERPARK AMBULATORY SURGERY CENTER
Street 107 FRONT STREET
City VIDALIA
State LA
ZIP 71373
Phone 318 336-2218
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 7/25/2025
Certificate Expiration Date 7/24/2027
Facility Type Ambulatory Surgery Center
Lab Director KAREN MARTIN

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