03D0895598 CLIA NUMBER - NORTHERN ARIZONA SURGICENTER

Laboratory Demographics

CLIA Number: 03D0895598

Facility Name: NORTHERN ARIZONA SURGICENTER

Facility Address:
1020 N SAN FRANCISCO STE 100
FLAGSTAFF, AZ
ZIP 86001
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Facility Phone Number: 928 774-3300

Facility Type: Ambulatory Surgery Center

Certificate Type: Waiver

NPI Number: 1871596114

Taxonomy: 261QA1903X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	03D0895598
LAB Type	Ambulatory Surgery Center
Facility Name	NORTHERN ARIZONA SURGICENTER
Street	1020 N SAN FRANCISCO STE 100
City	FLAGSTAFF
State	AZ
ZIP	86001
Phone	928 774-3300
CertificateType	4
CertificateEffectiveDate	12/13/2022
CertificateExpirationDate	12/12/2024
FacilityType	Waiver

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