03D2047048 CLIA NUMBER - PRESCOTT HEALTHCARE SOLUTIONS, LLC DBA OPTIMA MEDICAL

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Laboratory Demographics

CLIA Number: 03D2047048

Facility Name: PRESCOTT HEALTHCARE SOLUTIONS, LLC DBA OPTIMA MEDICAL

Facility Address:
87 S STATE ROUTE 89
CHINO VALLEY, AZ
ZIP 86323
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Facility Phone Number: 480 660-6706

Facility Type: Practitioner Other

Certificate Type: Waiver

NPI Number: 1104090737

Taxonomy: 332H00000X - Eyewear Supplier
An organization that provides spectacles, contact lenses, and other vision enhancement devices prescribed by an optometrist or ophthalmologist.

CLIA Record

Field Name	Field Value
CLIA Number	03D2047048
LAB Type	Practitioner Other
Facility Name	PRESCOTT HEALTHCARE SOLUTIONS, LLC DBA OPTIMA MEDICAL
Street	87 S STATE ROUTE 89
City	CHINO VALLEY
State	AZ
ZIP	86323
Phone	480 660-6706
CertificateType	4
CertificateEffectiveDate	9/17/2022
CertificateExpirationDate	9/16/2024
FacilityType	Waiver

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