36D1059172 CLIA NUMBER - REVISION ADVANCED SURGERY CENTER

Laboratory Demographics

CLIA Number: 36D1059172

Facility Name: REVISION ADVANCED SURGERY CENTER

Facility Address:
1080 POLARIS PARKWAY SUITE 100
COLUMBUS, OH
ZIP 43240
Get Directions

Facility Phone Number: 614 781-0499

Facility Type: Ambulatory Surgery Center

Certificate Type: Waiver

NPI Number: 1609974401

Taxonomy: 261QA1903X - Clinic/Center

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
CertificateType	4
CertificateEffectiveDate	9/25/2022
CertificateExpirationDate	9/24/2024
FacilityType	Waiver

Download Record

Export to text format icon Download this CLIA NUMBER record in Text format: Export

Export to text format icon Download this CLIA NUMBER record in Excel (CSV) format: Export

Export to text format icon Download this CLIA NUMBER record in XML format: Export

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