03D2006149 CLIA NUMBER - PRESCOTT HEALTHCARE SOLUTIONS LLC DBA OPTIMA MEDICAL

Laboratory Demographics

  • CLIA Code: 03D2006149
  • Facility Name: PRESCOTT HEALTHCARE SOLUTIONS LLC DBA OPTIMA MEDICAL
  • Facility Address: 4365 E PECOS RD STE 134
    GILBERT, AZ
    ZIP 85295
  • Facility Phone: 480 840-9155
  • Facility Type: Physician Office
  • Facility Type: Microscopy
  • Lab Director: TIMOTHY BRYAN
  • NPI Number: 1124224126
  • Taxonomy: 207Q00000X - Family Medicine

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CLIA Record

Field Name Field Value
CLIA Number 03D2006149
LAB Type Physician Office
Facility Name PRESCOTT HEALTHCARE SOLUTIONS LLC DBA OPTIMA MEDICAL
Street 4365 E PECOS RD STE 134
City GILBERT
State AZ
ZIP 85295
Phone 480 840-9155
Certificate Type Certificate for Provider-Performed Microscopy Procedures (PPMP)
Certificate Type Description This certificate is issued to a laboratory in which a physician, midlevel practitioner or dentist performs no tests other than the microscopy procedures. This certificate permits the laboratory to also perform waived tests.
Certificate Effective Date 4/13/2024
Certificate Expiration Date 4/12/2026
Facility Type Physician Office
Lab Director TIMOTHY BRYAN

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