03D1059537 CLIA NUMBER - SUMMIT HEALTHCARE FAMILY MEDICINE AT BISON RANCH

Laboratory Demographics

  • CLIA Code: 03D1059537
  • Facility Name: SUMMIT HEALTHCARE FAMILY MEDICINE AT BISON RANCH
  • Facility Address: 2352 QUARTER HORSE TRAIL
    OVERGAARD, AZ
    ZIP 85933
  • Facility Phone: 928 535-3616
  • Facility Type: Community Clinic
  • Facility Type: Waiver
  • Lab Director: DR. NATHAN BROOKS
  • NPI Number: 1326549031
  • Taxonomy: 332900000X - Non-Pharmacy Dispensing Site

Map and Directions

Get Directions

CLIA Record

Field Name Field Value
CLIA Number 03D1059537
LAB Type Community Clinic
Facility Name SUMMIT HEALTHCARE FAMILY MEDICINE AT BISON RANCH
Street 2352 QUARTER HORSE TRAIL
City OVERGAARD
State AZ
ZIP 85933
Phone 928 535-3616
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 10/2/2024
Certificate Expiration Date 10/1/2026
Facility Type Community Clinic
Lab Director DR. NATHAN BROOKS

Download Record

Download this CLIA record record in Text format: Export

Download this CLIA record record in Excel (CSV) format: Export

Download this CLIA record record in XML format: Export

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