03D2113734 CLIA NUMBER - BANNER - UNIVERSITY MEDICAL GROUP

Laboratory Demographics

CLIA Number: 03D2113734

Facility Name: BANNER - UNIVERSITY MEDICAL GROUP

Facility Address:
535 N WILMOT RD, 2ND FLOOR
TUCSON, AZ
ZIP 85711
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Facility Phone Number: (520) 694-1234

Facility Type: PHYSICIAN OFFICE

Certificate Type: Waiver

NPI Number: 1922660109

Taxonomy: 261QA1903X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	03D2113734
LAB Type	PHYSICIAN OFFICE
Facility Name	BANNER - UNIVERSITY MEDICAL GROUP
Street	535 N WILMOT RD, 2ND FLOOR
City	TUCSON
State	AZ
ZIP	85711
Phone	(520) 694-1234

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This page was last updated on: 5/11/2023