03D2021819 CLIA NUMBER - BANNER - UNIVERSITY MEDICAL GROUP

Home > CLIA Lookup > 03D2021819

Laboratory Demographics

CLIA Number: 03D2021819

Facility Name: BANNER - UNIVERSITY MEDICAL GROUP

Facility Address:
707 N ALVERNON WAY STE 101 & 201
TUCSON, AZ
ZIP 85711
Get Directions

Facility Phone Number: 520 694-1611

Facility Type: Physician Office

Certificate Type: Microscopy

NPI Number: 1568818649

Taxonomy: 261QM0850X - Clinic/Center
An entity, facility, or distinct part of a facility providing diagnostic, treatment, and prescriptive services related to mental and behavioral disorders in adults.

CLIA Record

Field Name	Field Value
CLIA Number	03D2021819
LAB Type	Physician Office
Facility Name	BANNER - UNIVERSITY MEDICAL GROUP
Street	707 N ALVERNON WAY STE 101 & 201
City	TUCSON
State	AZ
ZIP	85711
Phone	520 694-1611
CertificateType	3
CertificateEffectiveDate	3/22/2023
CertificateExpirationDate	3/21/2025
FacilityType	PPMP

Download Record

Export to text format icon Download this CLIA NUMBER record in Text format: Export

Export to text format icon Download this CLIA NUMBER record in Excel (CSV) format: Export

Export to text format icon Download this CLIA NUMBER record in XML format: Export

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