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Tri State Medical Alliance Llc
Physiological Laboratory in Fort Mohave, Arizona
NPI 1518472950

Tri State Medical Alliance Llc is a Physiological Laboratory based in Fort Mohave, AZ. Tri State Medical Alliance Llc practices in Fort Mohave, AZ. The NPI Number for Tri State Medical Alliance Llc is 1518472950 and holds a License No. (Arizona).

The current practice location address for Tri State Medical Alliance Llc is 1510 E Wagon Wheel Ln Ste 103, Fort Mohave, AZ and can be reached out via phone at 928-460-7226 and via fax at 928-447-6113.

Location: 1510 E Wagon Wheel Ln Ste 103, Fort Mohave, AZ, 86426-6698
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
institution
Provider Profile Details
NPI Number
1518472950
Provider Name
Tri State Medical Alliance Llc
Credential
Provider Entity Type
Organization
Address
1510 E Wagon Wheel Ln Ste 103, Fort Mohave, AZ, 86426-6698
Phone Number
928-460-7226
Fax Number
928-447-6113
Provider Enumeration Date
12/07/2017
Last Update Date
03/13/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
L22382013 01 AZ CORPORATION ID#
557885 05 AZ
institution
Provider Business Practice Location Address Details
Address
1510 E Wagon Wheel Ln Ste 103
City
Fort Mohave
State
Arizona
Zip
86426-6698
Phone Number
928-460-7226
Fax Number
928-447-6113
person
Provider Business Mailing Address Details
Address
1510 E Wagon Wheel Ln Ste 103
City
Fort Mohave
State
Arizona
Zip
86426-6698
Phone Number
928-460-7226
Fax Number
928-447-6113
person
Provider's Taxonomy Details 1
Type
Ambulatory Health Care Facilities
Classification
Clinic/Center
Speciality
Radiology
Taxonomy
261QR0200X
License No.
()
Definition
Definition to come...
person
Provider's Taxonomy Details 2
Type
Laboratories
Classification
Physiological Laboratory
Speciality
-
Taxonomy
293D00000X
License No.
()
Definition
A laboratory that operates independently of a hospital and physician's office to furnish physiological diagnostic services (e.g. EEG's , EKG's, scans, etc.). Facilities offering ONLY physiological services are not certified as independent laboratories. If an independent laboratory offers physiological services IN ADDITION to clinical laboratory services, they are surveyed only for compliance with the clinical laboratory regulations because there are no health and safety regulations for physiological services.
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