03D0712494 CLIA NUMBER - PHOENIX EYE SURGICAL CENTER LLC

Laboratory Demographics

  • CLIA Code: 03D0712494
  • Facility Name: PHOENIX EYE SURGICAL CENTER LLC
  • Facility Address: 5133 N CENTRAL AVE STE 100
    PHOENIX, AZ
    ZIP 85012
  • Facility Phone: 602 279-0044
  • Facility Type: Ambulatory Surgery Center
  • Facility Type: Waiver
  • Lab Director: NICHOLE E. VAUGHAN
  • NPI Number: 1013021682
  • Taxonomy: 261QA1903X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 03D0712494
LAB Type Ambulatory Surgery Center
Facility Name PHOENIX EYE SURGICAL CENTER LLC
Street 5133 N CENTRAL AVE STE 100
City PHOENIX
State AZ
ZIP 85012
Phone 602 279-0044
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 9/1/2024
Certificate Expiration Date 8/31/2026
Facility Type Ambulatory Surgery Center
Lab Director NICHOLE E. VAUGHAN

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This page was last updated on: 3/20/2025