03D2126553 CLIA NUMBER - BANNER - UMG INTEGRATED HEALTH CLINIC LLC

Laboratory Demographics

  • CLIA Code: 03D2126553
  • Facility Name: BANNER - UMG INTEGRATED HEALTH CLINIC LLC
  • Facility Address: 535 N WILMOT RD, 2ND FLOOR
    TUCSON, AZ
    ZIP 85711
  • Facility Phone: 520 694-1234
  • Facility Type: Other - INTEGRATED HEALTH CLINIC
  • Facility Type: Microscopy
  • Lab Director: ANN MATHIAS
  • NPI Number: 1568818649
  • Taxonomy: 261QM0850X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 03D2126553
LAB Type Other - INTEGRATED HEALTH CLINIC
Facility Name BANNER - UMG INTEGRATED HEALTH CLINIC LLC
Street 535 N WILMOT RD, 2ND FLOOR
City TUCSON
State AZ
ZIP 85711
Phone 520 694-1234
Certificate Type Certificate for Provider-Performed Microscopy Procedures (PPMP)
Certificate Type Description This certificate is issued to a laboratory in which a physician, midlevel practitioner or dentist performs no tests other than the microscopy procedures. This certificate permits the laboratory to also perform waived tests.
Certificate Effective Date 8/17/2024
Certificate Expiration Date 8/16/2026
Facility Type Other - INTEGRATED HEALTH CLINIC
Lab Director ANN MATHIAS

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