03D2126991 CLIA NUMBER - OPTIMUM SURGICAL CENTER

Laboratory Demographics

CLIA Number: 03D2126991

Facility Name: OPTIMUM SURGICAL CENTER

Facility Address:
20045 N 19TH AVE, BLDG 12
PHOENIX, AZ
ZIP 85027
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Facility Phone Number: (480) 799-6819

Facility Type: AMBULATORY SURGERY CENTER

Certificate Type: Waiver

NPI Number: 1992238661

Taxonomy: 261QA1903X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	03D2126991
LAB Type	AMBULATORY SURGERY CENTER
Facility Name	OPTIMUM SURGICAL CENTER
Street	20045 N 19TH AVE, BLDG 12
City	PHOENIX
State	AZ
ZIP	85027
Phone	(480) 799-6819

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This page was last updated on: 5/11/2023