36D1059172 CLIA NUMBER - REVISION ADVANCED SURGERY CENTER

Laboratory Demographics

  • CLIA Code: 36D1059172
  • Facility Name: REVISION ADVANCED SURGERY CENTER
  • Facility Address: 1080 POLARIS PARKWAY SUITE 100
    COLUMBUS, OH
    ZIP 43240
  • Facility Phone: 614 781-0499
  • Facility Type: Ambulatory Surgery Center
  • Facility Type: Waiver
  • Lab Director: D JAMES SCHUMER
  • NPI Number: 1609974401
  • Taxonomy: 261QA1903X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 36D1059172
LAB Type Ambulatory Surgery Center
Facility Name REVISION ADVANCED SURGERY CENTER
Street 1080 POLARIS PARKWAY SUITE 100
City COLUMBUS
State OH
ZIP 43240
Phone 614 781-0499
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 9/25/2024
Certificate Expiration Date 9/24/2026
Facility Type Ambulatory Surgery Center
Lab Director D JAMES SCHUMER

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