03D0673262 CLIA NUMBER - CANYON VISTA MEDICAL GROUP/OBGYN

Laboratory Demographics

  • CLIA Code: 03D0673262
  • Facility Name: CANYON VISTA MEDICAL GROUP/OBGYN
  • Facility Address: 5750 E HIGHWAY 90, STE 300
    SIERRA VISTA, AZ
    ZIP 85635
  • Facility Phone: 520 263-3620
  • Facility Type: Physician Office
  • Facility Type: Microscopy
  • Lab Director: SIDNEY SEMRAD
  • NPI Number: 1992142921
  • Taxonomy: 207ZP0102X - Pathology

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CLIA Record

Field Name Field Value
CLIA Number 03D0673262
LAB Type Physician Office
Facility Name CANYON VISTA MEDICAL GROUP/OBGYN
Street 5750 E HIGHWAY 90, STE 300
City SIERRA VISTA
State AZ
ZIP 85635
Phone 520 263-3620
Certificate Type Certificate for Provider-Performed Microscopy Procedures (PPMP)
Certificate Type Description This certificate is issued to a laboratory in which a physician, midlevel practitioner or dentist performs no tests other than the microscopy procedures. This certificate permits the laboratory to also perform waived tests.
Certificate Effective Date 9/1/2024
Certificate Expiration Date 8/31/2026
Facility Type Physician Office
Lab Director SIDNEY SEMRAD

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