03D1055909 CLIA NUMBER - TRI-CITY SURGERY CENTER

Laboratory Demographics

CLIA Number: 03D1055909

Facility Name: TRI-CITY SURGERY CENTER

Facility Address:
5430 DISTINCTION WAY
PRESCOTT, AZ
ZIP 86301
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Facility Phone Number: 928 445-1919

Facility Type: Ambulatory Surgery Center

Certificate Type: Waiver

NPI Number: 1598229593

Taxonomy: 207RG0100X - Internal Medicine
An internist who specializes in diagnosis and treatment of diseases of the digestive organs including the stomach, bowels, liver and gallbladder. This specialist treats conditions such as abdominal pain, ulcers, diarrhea, cancer and jaundice and performs complex diagnostic and therapeutic procedures using endoscopes to visualize internal organs.

CLIA Record

Field Name	Field Value
CLIA Number	03D1055909
LAB Type	Ambulatory Surgery Center
Facility Name	TRI-CITY SURGERY CENTER
Street	5430 DISTINCTION WAY
City	PRESCOTT
State	AZ
ZIP	86301
Phone	928 445-1919
CertificateType	4
CertificateEffectiveDate	6/29/2022
CertificateExpirationDate	6/28/2024
FacilityType	Waiver

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