03D0890344 CLIA NUMBER - PRESCOTT HEALTHCARE SOLUTIONS LLC DBA OPTIMA MEDICAL

Laboratory Demographics

CLIA Number: 03D0890344

Facility Name: PRESCOTT HEALTHCARE SOLUTIONS LLC DBA OPTIMA MEDICAL

Facility Address:
725 W ELLIOT RD BLDG 3 STE 105
GILBERT, AZ
ZIP 85233
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Facility Phone Number: 480 963-6144

Facility Type: Physician Office

Certificate Type: Microscopy

NPI Number: 1629182746

Taxonomy: 207QG0300X - Family Medicine
A family medicine physician with special knowledge of the aging process and special skills in the diagnostic, therapeutic, preventive and rehabilitative aspects of illness in the elderly. This specialist cares for geriatric patients in the patient's home, the office, long-term care settings such as nursing homes, and the hospital.

CLIA Record

Field Name	Field Value
CLIA Number	03D0890344
LAB Type	Physician Office
Facility Name	PRESCOTT HEALTHCARE SOLUTIONS LLC DBA OPTIMA MEDICAL
Street	725 W ELLIOT RD BLDG 3 STE 105
City	GILBERT
State	AZ
ZIP	85233
Phone	480 963-6144
CertificateType	3
CertificateEffectiveDate	8/16/2022
CertificateExpirationDate	8/15/2024
FacilityType	PPMP

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