03D2119948 CLIA NUMBER - DESERT SPURS PRIMARY CARE, PLLC

Laboratory Demographics

  • CLIA Code: 03D2119948
  • Facility Name: DESERT SPURS PRIMARY CARE, PLLC
  • Facility Address: 2400 HIGHWAY 95 STE 50
    BULLHEAD CITY, AZ
    ZIP 86442
  • Facility Phone: 928 444-8405
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: ROBERT J. BAZACO
  • NPI Number: 1730634965
  • Taxonomy: 207Q00000X - Family Medicine

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CLIA Record

Field Name Field Value
CLIA Number 03D2119948
LAB Type Physician Office
Facility Name DESERT SPURS PRIMARY CARE, PLLC
Street 2400 HIGHWAY 95 STE 50
City BULLHEAD CITY
State AZ
ZIP 86442
Phone 928 444-8405
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 10/6/2024
Certificate Expiration Date 10/5/2026
Facility Type Physician Office
Lab Director ROBERT J. BAZACO

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This page was last updated on: 6/4/2025