03D2123973 CLIA NUMBER - Bdpec Asc Lake Havasu City

Laboratory Demographics

CLIA Number: 03D2123973

Facility Name: Bdpec Asc Lake Havasu City

Facility Address:
40 Capri Blvd, Ste 102,
Lake Havasu City, AZ
ZIP 86403
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Facility Phone Number: (602) 508-4843

Facility Type: AMBULATORY SURGERY CENTER

Certificate Type: Waiver

NPI Number: 1497727093
261QA1903X - Clinic/Center

CLIA Record

Field Name Field Value
CLIA Number 03D2123973
LAB Type AMBULATORY SURGERY CENTER
Facility Name Bdpec Asc Lake Havasu City
Street 40 Capri Blvd, Ste 102,
City Lake Havasu City
State AZ
ZIP 86403
Phone 6025084843

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This page was last updated on: 5/19/2019