03D2116509 CLIA NUMBER - PRIVIA MEDICAL GROUP ARIZONA, LLC

Laboratory Demographics

  • CLIA Code: 03D2116509
  • Facility Name: PRIVIA MEDICAL GROUP ARIZONA, LLC
  • Facility Address: 16928 W BELL RD STE 702
    SURPRISE, AZ
    ZIP 85374
  • Facility Phone: 623 633-3848
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: RIYAZ A. SUMAR
  • NPI Number: 1083273585
  • Taxonomy: 207Q00000X - Family Medicine

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CLIA Record

Field Name Field Value
CLIA Number 03D2116509
LAB Type Physician Office
Facility Name PRIVIA MEDICAL GROUP ARIZONA, LLC
Street 16928 W BELL RD STE 702
City SURPRISE
State AZ
ZIP 85374
Phone 623 633-3848
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 7/27/2024
Certificate Expiration Date 7/26/2026
Facility Type Physician Office
Lab Director RIYAZ A. SUMAR

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