LAKE HAVASU PEDIATRIC FAMILY CLINIC
NPI 1154051753
Clinic/Center - Multi-Specialty in Lake Havasu City, AZ
NPI Status: Active since June 15, 2022
Contact Information
1980 MESQUITE AVE
LAKE HAVASU CITY, AZ
ZIP 86403
Phone: (928) 392-3691
Fax: (928) 392-3693
- Organization
- Clinic/Center
- Multi-Specialty
- Accepts Insurance
- CLIA Number: 03D1017038
- CLIA Cert. Type: Community Clinic
- CLIA Exp. Date: 05-22-2026
About LAKE HAVASU PEDIATRIC FAMILY CLINIC
This page provides the complete NPI Profile along with additional information for Lake Havasu Pediatric Family Clinic, a provider established in Lake Havasu City, Arizona operating as a Clinic/center, focusing in multi-specialty . The healthcare provider is registered in the NPI registry with number 1154051753 assigned on June 2022. The practitioner's primary taxonomy code is 261QM1300X. The provider is registered as an organization and their NPI record was last updated 3 years ago. The provider's is doing business as Lake Havasu Pediatric Family Clinic. The authorized official of this NPI record is Amanda Aguirre (President & Ceo)
- NPI
- 1154051753
- Provider Legal Name
- SAN LUIS WALK-IN CLINIC, INC.
- Other Organization Name
- LAKE HAVASU PEDIATRIC FAMILY CLINIC
- Other Name Type
- Doing Business As (3)
- Entity Type
- Organization
- Location Address
- 1980 MESQUITE AVE LAKE HAVASU CITY, AZ 86403
- Location Phone
- (928) 392-3691
- Location Fax
- (928) 392-3693
- Mailing Address
- PO BOX 617 SOMERTON, AZ 85350
- Mailing Phone
- (928) 315-7910
- Mailing Fax
- (928) 392-3693
- Is Sole Proprietor?
- No
- Is Organization Subpart?
- No
- Enumeration Date
- 06-15-2022
- Last Update Date
- 09-07-2023
- Code Navigator
Location Map
Specialty - Primary Taxonomy
The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.
- Classification
Clinic/Center Multi-Specialty
- Taxonomy Code
- 261QM1300X
- Type
- Ambulatory Health Care Facilities
Insurance Plans Accepted
According to publicly available information the provider might be accepting the following health plans from these health insurance companies:
- Choice Bronze HSA - HMO
- Choice Bronze HSA + Vision + Adult Dental - HMO
- Complete Gold - HMO
- Complete Gold + Vision + Adult Dental - HMO
- Complete Silver - HMO
- Complete Silver + Vision + Adult Dental - HMO
- Elite Gold - HMO
- Elite Gold + Vision + Adult Dental - HMO
- Everyday Bronze - HMO
- Everyday Bronze + Vision + Adult Dental - HMO
- Standard Expanded Bronze - HMO
- Standard Expanded Bronze + Vision + Adult Dental - HMO
- Standard Gold - HMO
- Standard Gold + Vision + Adult Dental - HMO
- Standard Silver - HMO
- Standard Silver + Vision + Adult Dental - HMO
- AZ Blue ACA StandardHealth Silver with Health Choice - HMO
*Please verify directly with this provider to make sure your insurance plan is currently accepted.
CLIA Information
The Clinical Laboratory Improvement Amendments (CLIA) of 1988 applies to facilities or sites that test human specimens for health assessment or to diagnose, prevent, or treat disease. The CLIA Program sets standards for clinical laboratory testing and issues certificates. The NPI / CLIA crosswalk information for this NPI number is:
- CLIA Number
- 03D1017038
- Facility Type
- Community Clinic
- Certificate Effective Date
- September 16, 2003
- Certificate Expiration Date
- May 22, 2026
- Laboratory Director
- KENNETH G. FLANAGAN
- Certificate Type
- Certificate of Accreditation
- Certificate Type Description
- This is a CLIA certificate is issued to Lake Havasu Pediatric Family Clinic on the basis of the laboratory's accreditation by an accreditation organization approved by CMS. This type of certificate is issued to a laboratories tha perform nonwaived (moderate and/or high complexity) testing.
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NPI NPI Number Validation
How NPI Validation Works
The NPI validation process uses the ISO-standard Luhn algorithm, a mathematical "handshake", to ensure that a provider's 10-digit ID is authentic and free of common typing errors.
To verify the NPI 1154051753, we treat the final digit (3) as the Check Digit—the target answer we need to reach. The process begins by taking the first nine digits and adding a constant value of 24, which accounts for the "80840" prefix required for all U.S. health identifiers. We then double every other digit starting from the right and sum the individual digits of those results together. For this specific NPI, that total comes to 47. The final step is to find the difference between that total and the next multiple of ten (50 - 47 = 3).
Digit-by-digit view
Use the first nine digits for the calculation. Starting from the right, double every other digit. The last digit is the check digit and is not part of the calculation.
Step 1: Double every other digit from the right
Starting with the rightmost digit of the first nine digits, double every other value. If doubling creates a two-digit number, add those digits together.
Step 2: Add all digits plus the NPI constant
Add the transformed values, the unchanged digits, and the constant 24.
Step 3: Find the amount needed to reach the next multiple of 10
The next multiple of ten after 47 is 50. The difference is the calculated check digit.
Other Providers at the Same Location
The following 1 provider is registered at the same or a nearby location.
LAKE HAVASU CITY, AZ 86403
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1154051753, enumerated as an "organization" on June 15, 2022.
The provider is located at 1980 MESQUITE AVE LAKE HAVASU CITY, AZ 86403 and the phone number is (928) 392-3691.
Clinic/Center with taxonomy code 261QM1300X and a focus in Multi-Specialty.
The provider might be accepting Accepts: Ambetter from Arizona Complete Health and Blue. Please consult your insurance carrier or call the provider to verify.
