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: 1568818649

Taxonomy: 261QM0850X - Clinic/Center
An entity, facility, or distinct part of a facility providing diagnostic, treatment, and prescriptive services related to mental and behavioral disorders in adults.

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: 4/7/2021