03D2114504 CLIA NUMBER - SURGICAL INSTITUTE OF TUCSON, LLC

Laboratory Demographics

CLIA Number: 03D2114504

Facility Name: SURGICAL INSTITUTE OF TUCSON, LLC

Facility Address:
4787 E CAMP LOWELL DR
TUCSON, AZ
ZIP 85712
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Facility Phone Number: 520 777-5966

Facility Type: Ambulatory Surgery Center

Certificate Type: Waiver

NPI Number: 1992168785

Taxonomy: 261QA1903X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	03D2114504
LAB Type	Ambulatory Surgery Center
Facility Name	SURGICAL INSTITUTE OF TUCSON, LLC
Street	4787 E CAMP LOWELL DR
City	TUCSON
State	AZ
ZIP	85712
Phone	520 777-5966
CertificateType	4
CertificateEffectiveDate	6/15/2022
CertificateExpirationDate	6/14/2024
FacilityType	Waiver

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