28D2167505 CLIA NUMBER - RIVERVIEW SURGICAL CENTER LLC

Laboratory Demographics

  • CLIA Code: 28D2167505
  • Facility Name: RIVERVIEW SURGICAL CENTER LLC
  • Facility Address: 201 E 4TH STREET
    SOUTH SIOUX CITY, NE
    ZIP 68776
  • Facility Phone: 402 412-2160
  • Facility Type: Ambulatory Surgery Center
  • Facility Type: Waiver
  • Lab Director: DR. PHINIT PHISITKUL
  • NPI Number: 1003374711
  • Taxonomy: 261QA1903X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 28D2167505
LAB Type Ambulatory Surgery Center
Facility Name RIVERVIEW SURGICAL CENTER LLC
Street 201 E 4TH STREET
City SOUTH SIOUX CITY
State NE
ZIP 68776
Phone 402 412-2160
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 6/10/2025
Certificate Expiration Date 6/9/2027
Facility Type Ambulatory Surgery Center
Lab Director DR. PHINIT PHISITKUL

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