19D2158275 CLIA NUMBER - RIVER CITIES INTERVENTIONAL PAIN SPECIALISTS

Laboratory Demographics

CLIA Number: 19D2158275

Facility Name: RIVER CITIES INTERVENTIONAL PAIN SPECIALISTS

Facility Address:
8731 PARK PLAZA DR
SHREVEPORT, LA
ZIP 71105
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Facility Phone Number: 318 797-5848

Facility Type: Physician Office

Certificate Type: Accreditation

NPI Number: 1710466628

Taxonomy: 261QM1300X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	19D2158275
LAB Type	Physician Office
Facility Name	RIVER CITIES INTERVENTIONAL PAIN SPECIALISTS
Street	8731 PARK PLAZA DR
City	SHREVEPORT
State	LA
ZIP	71105
Phone	318 797-5848
CertificateType	1
CertificateEffectiveDate	3/4/2024
CertificateExpirationDate	3/3/2026
FacilityType	Accreditation

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