03D2152330 CLIA NUMBER - INTERMOUNTAIN HEALTH CENTER, INC

Laboratory Demographics

  • CLIA Code: 03D2152330
  • Facility Name: INTERMOUNTAIN HEALTH CENTER, INC
  • Facility Address: 5055 E BROADWAY BLVD STE C104
    TUCSON, AZ
    ZIP 85711
  • Facility Phone: 520 721-1887
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: LINDSEY RETTERATH
  • NPI Number: 1205164605
  • Taxonomy: 251S00000X - Community/Behavioral Health

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CLIA Record

Field Name Field Value
CLIA Number 03D2152330
LAB Type Physician Office
Facility Name INTERMOUNTAIN HEALTH CENTER, INC
Street 5055 E BROADWAY BLVD STE C104
City TUCSON
State AZ
ZIP 85711
Phone 520 721-1887
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 8/7/2024
Certificate Expiration Date 8/6/2026
Facility Type Physician Office
Lab Director LINDSEY RETTERATH

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This page was last updated on: 9/29/2025