03D2094842 CLIA NUMBER - TRIDENT HEALTH CENTER

Laboratory Demographics

  • CLIA Code: 03D2094842
  • Facility Name: TRIDENT HEALTH CENTER
  • Facility Address: 20340 N LAKE PLEASANT RD, STE 109
    PEORIA, AZ
    ZIP 85382
  • Facility Phone: 623 299-9988
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: ARVIND MAHADEVAN
  • NPI Number: 1902204191
  • Taxonomy: 261QP2300X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 03D2094842
LAB Type Physician Office
Facility Name TRIDENT HEALTH CENTER
Street 20340 N LAKE PLEASANT RD, STE 109
City PEORIA
State AZ
ZIP 85382
Phone 623 299-9988
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 4/24/2025
Certificate Expiration Date 4/23/2027
Facility Type Physician Office
Lab Director ARVIND MAHADEVAN

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