03D2111194 CLIA NUMBER - SCOTTSDALE MCCORMICK RANCH SURGICENTER

Laboratory Demographics

CLIA Number: 03D2111194

Facility Name: SCOTTSDALE MCCORMICK RANCH SURGICENTER

Facility Address:
8129 N 87TH PLACE #100
SCOTTSDALE, AZ
ZIP 85258
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Facility Phone Number: 480 410-4012

Facility Type: Ambulatory Surgery Center

Certificate Type: Waiver

NPI Number: 1023523396

Taxonomy: 261QD0000X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	03D2111194
LAB Type	Ambulatory Surgery Center
Facility Name	SCOTTSDALE MCCORMICK RANCH SURGICENTER
Street	8129 N 87TH PLACE #100
City	SCOTTSDALE
State	AZ
ZIP	85258
Phone	480 410-4012
CertificateType	4
CertificateEffectiveDate	4/1/2024
CertificateExpirationDate	3/31/2026
FacilityType	Waiver

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