03D2136847 CLIA NUMBER - AKDHC - SIERRA VISTA

Laboratory Demographics

CLIA Number: 03D2136847

Facility Name: AKDHC - SIERRA VISTA

Facility Address:
5555 MESA VERDE DR, STE 100
SIERRA VISTA, AZ
ZIP 85635
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Facility Phone Number: 520 585-4741

Facility Type: Physician Office

Certificate Type: Microscopy

NPI Number: 1730566118

Taxonomy: 207RN0300X - Internal Medicine
An internist who treats disorders of the kidney, high blood pressure, fluid and mineral balance and dialysis of body wastes when the kidneys do not function. This specialist consults with surgeons about kidney transplantation.

CLIA Record

Field Name	Field Value
CLIA Number	03D2136847
LAB Type	Physician Office
Facility Name	AKDHC - SIERRA VISTA
Street	5555 MESA VERDE DR, STE 100
City	SIERRA VISTA
State	AZ
ZIP	85635
Phone	520 585-4741
CertificateType	3
CertificateEffectiveDate	9/18/2023
CertificateExpirationDate	9/17/2025
FacilityType	PPMP

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This page was last updated on: 4/23/2024