1. Home
  2. Directory
  3. Arizona
  4. Bullhead City
  5. Clinic Center
  6. NPI Profile

RIVIERA SURGICAL CENTER LLC
NPI 1073107850
Clinic/Center - Ambulatory Surgical in Bullhead City, AZ

Active since February 23, 2021CLIA 03D2214737 · Waiver
3003 AZ-95, #63, BULLHEAD CITY, AZ 86442(909) 994-5105 Get Directions Write a Review

NPPES record last updated: December 17, 2025. Verified against the NPPES registry weekly; last sync: August 16, 2026.

Record update history: Dec 17, 2025, Dec 11, 2025, Apr 28, 2021 and 1 more (4 updates tracked since 2021).

About Riviera Surgical Center Llc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

RIVIERA SURGICAL CENTER LLC (NPI 1073107850) is a healthcare organization registered as an ambulatory surgical in Bullhead City, Arizona and active in the NPI registry since February 2021. The organization holds a CLIA Waiver certificate valid through February 23, 2027 and lists Jack Diep, Administrator, as its authorized official.

NPPES Registry Identity

NPI1073107850
Entity TypeOrganization
Primary Taxonomy261QA1903X
Legal Business NameRIVIERA SURGICAL CENTER LLC
Location Address3003 AZ-95, #63Bullhead City, AZ 86442
Mailing Address3003 Az-95, #63Bullhead City, AZ 86442 · (928) 483-4566 · Fax (928) 483-4566
Phone(909) 994-5105
Organization SubpartNo
Authorized OfficialJack DiepAdministrator · (928) 505-7246
Enumeration DateFebruary 23, 2021
Last NPPES UpdateDecember 17, 20254 updates tracked since enumeration
NPPES CertifiedDecember 17, 2025
✔ NPI 1073107850 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyClinic/Center · Ambulatory SurgicalAmbulatory Health Care Facilities
Taxonomy Code261QA1903X
3003 AZ-95, Bullhead City, AZ 86442
Open in Google Maps ↗

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 03D2214737

Riviera Surgical Center LLC · Bullhead City, AZ
Active · expires Feb 23, 2027
CLIA Number03D2214737
Laboratory TypeAmbulatory Surgery Center
Certificate Effective DateFebruary 24, 2025
Certificate Expiration DateFebruary 23, 2027
Laboratory DirectorAndrew W. Hesseltine
Laboratory Phone(909) 994-5105
Laboratory LocationRiviera Surgical Center LLC3003 Az-95 Suite 63, Bullhead City, AZ 86442
CLIA data matches this NPI record on: Address Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Areas of Expertise CMS Part B claims 4

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Insertion of spinal neurostimulator electrode array through skin 63650
This procedure involves placing a small device, called a neurostimulator electrode array, under your skin near your spine. It delivers mild electrical signals to your spinal cord, helping to manage chronic pain.
38 services17 patients
Removal of bone from lower spine for decompression of nerve tissue using imaging guidance, accessed through the skin 0275T
This procedure involves removing a small portion of bone from your lower spine. The goal is to relieve pressure on your nerve tissue, improving comfort and mobility. It is done through the skin using imaging technology to ensure precision and safety.
13 services13 patients
Insertion or replacement of spinal neurostimulator generator or receiver 63685
The insertion of a spinal neurostimulator generator or receiver is a procedure to manage chronic pain. A small device is implanted under your skin, which sends mild electrical signals to your spinal cord. These signals disrupt pain signals, helping to reduce discomfort.
13 services13 patients
Heat destruction of intraosseous basivertebral nerve in bones of spine in lower back, first two bones 64628
This procedure involves the use of heat to disable the basivertebral nerve within the first two bones of your lower spine. It's done to alleviate chronic lower back pain. It's a safe, minimally invasive procedure with a quick recovery time.
12 services12 patients

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Riviera Surgical Center LLC's NPI number?

The NPI number for Riviera Surgical Center LLC is 1073107850. It was assigned to this organization in the NPPES registry on February 23, 2021.

Where is Riviera Surgical Center LLC located?

Riviera Surgical Center LLC is located at 3003 Az-95 #63, Bullhead City, AZ 86442. The listed phone number is (909) 994-5105.

What is Riviera Surgical Center LLC's specialty?

The primary specialty registered for this NPI is Clinic/Center, specializing in Ambulatory Surgical, with taxonomy code 261QA1903X.

Does Riviera Surgical Center LLC hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 03D2214737) is associated with this NPI, valid through February 23, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Riviera Surgical Center LLC was last updated on December 17, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 8 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.