03D2064451 CLIA NUMBER - BANNER PRIMARY CARE PHYSICIANS ARIZONA

Laboratory Demographics

  • CLIA Code: 03D2064451
  • Facility Name: BANNER PRIMARY CARE PHYSICIANS ARIZONA
  • Facility Address: 3235 N HUNT HIGHWAY, STE 103
    FLORENCE, AZ
    ZIP 85132
  • Facility Phone: 520 233-2770
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: RUBEN ESPINOZA
  • NPI Number: 1659640902
  • Taxonomy: 261QP2300X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 03D2064451
LAB Type Physician Office
Facility Name BANNER PRIMARY CARE PHYSICIANS ARIZONA
Street 3235 N HUNT HIGHWAY, STE 103
City FLORENCE
State AZ
ZIP 85132
Phone 520 233-2770
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 8/20/2023
Certificate Expiration Date 8/19/2025
Facility Type Physician Office
Lab Director RUBEN ESPINOZA

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This page was last updated on: 6/4/2025