03D2204611 CLIA NUMBER - BRIDGEWATER LA CHOLLA OPERATIONS, LLC

Laboratory Demographics

  • CLIA Code: 03D2204611
  • Facility Name: BRIDGEWATER LA CHOLLA OPERATIONS, LLC
  • Facility Address: 6505 N LA CHOLLA BLVD
    TUCSON, AZ
    ZIP 85741
  • Facility Phone: 520 904-0517
  • Facility Type: Assisted Living Facility
  • Facility Type: Waiver
  • Lab Director: LUPITA AGUIRRE
  • NPI Number: 1356963086
  • Taxonomy: 310400000X - Assisted Living Facility

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CLIA Record

Field Name Field Value
CLIA Number 03D2204611
LAB Type Assisted Living Facility
Facility Name BRIDGEWATER LA CHOLLA OPERATIONS, LLC
Street 6505 N LA CHOLLA BLVD
City TUCSON
State AZ
ZIP 85741
Phone 520 904-0517
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 12/9/2024
Certificate Expiration Date 12/8/2026
Facility Type Assisted Living Facility
Lab Director LUPITA AGUIRRE

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This page was last updated on: 3/20/2025