03D2299139 CLIA NUMBER - YAVAPAI PRIMARY CARE

Laboratory Demographics

  • CLIA Code: 03D2299139
  • Facility Name: YAVAPAI PRIMARY CARE
  • Facility Address: 6496 E HWY 69
    PRESCOTT VALLEY, AZ
    ZIP 86314
  • Facility Phone: 928 350-8780
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: SEAN TESSMAN
  • NPI Number: 1346871076
  • Taxonomy: 207Q00000X - Family Medicine

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CLIA Record

Field Name Field Value
CLIA Number 03D2299139
LAB Type Physician Office
Facility Name YAVAPAI PRIMARY CARE
Street 6496 E HWY 69
City PRESCOTT VALLEY
State AZ
ZIP 86314
Phone 928 350-8780
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 2/14/2024
Certificate Expiration Date 2/13/2026
Facility Type Physician Office
Lab Director SEAN TESSMAN

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