03D2173701 CLIA NUMBER - PISA ASC HOLDCO LLC

Laboratory Demographics

  • CLIA Code: 03D2173701
  • Facility Name: PISA ASC HOLDCO LLC
  • Facility Address: 4741 E CAMP LOWELL DR
    TUCSON, AZ
    ZIP 85712
  • Facility Phone: 520 318-6035
  • Facility Type: Ambulatory Surgery Center
  • Facility Type: Waiver
  • Lab Director: EFRAIN CUBILLO
  • NPI Number: 1174185649
  • Taxonomy: 261QA1903X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 03D2173701
LAB Type Ambulatory Surgery Center
Facility Name PISA ASC HOLDCO LLC
Street 4741 E CAMP LOWELL DR
City TUCSON
State AZ
ZIP 85712
Phone 520 318-6035
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 10/17/2025
Certificate Expiration Date 10/16/2027
Facility Type Ambulatory Surgery Center
Lab Director EFRAIN CUBILLO

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