44D1029640 CLIA NUMBER - RIDGE LAKE AMBULATORY SURGERY CENTER

Laboratory Demographics

  • CLIA Code: 44D1029640
  • Facility Name: RIDGE LAKE AMBULATORY SURGERY CENTER
  • Facility Address: 825 RIDGE LAKE BLVD
    MEMPHIS, TN
    ZIP 38120
  • Facility Phone: 901 685-2200
  • Facility Type: Ambulatory Surgery Center
  • Facility Type: Waiver
  • Lab Director: ANDREW CROTHERS
  • NPI Number: 1790844132
  • Taxonomy: 261QS0132X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 44D1029640
LAB Type Ambulatory Surgery Center
Facility Name RIDGE LAKE AMBULATORY SURGERY CENTER
Street 825 RIDGE LAKE BLVD
City MEMPHIS
State TN
ZIP 38120
Phone 901 685-2200
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 8/20/2024
Certificate Expiration Date 8/19/2026
Facility Type Ambulatory Surgery Center
Lab Director ANDREW CROTHERS

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