03D2146491 CLIA NUMBER - CORONADO SURGERY CENTER

Laboratory Demographics

CLIA Number: 03D2146491

Facility Name: CORONADO SURGERY CENTER

Facility Address:
150 S CORONADO DR STE 100
SIERRA VISTA, AZ
ZIP 85635
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Facility Phone Number: 520 335-8450

Facility Type: Ambulatory Surgery Center

Certificate Type: Waiver

NPI Number: 1215489182

Taxonomy: 261QA1903X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	03D2146491
LAB Type	Ambulatory Surgery Center
Facility Name	CORONADO SURGERY CENTER
Street	150 S CORONADO DR STE 100
City	SIERRA VISTA
State	AZ
ZIP	85635
Phone	520 335-8450
CertificateType	4
CertificateEffectiveDate	3/29/2024
CertificateExpirationDate	3/28/2026
FacilityType	Waiver

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