HAVASU SURGERY CENTER
NPI 1386619484
Clinic/Center - Ambulatory Surgical in Lake Havasu City, AZ
NPI Status: Active since February 22, 2006
Contact Information
1775 MCCULLOCH BLVD
LAKE HAVASU CITY, AZ
ZIP 86403
Phone: (928) 453-4200
Fax: (928) 453-8271
- Organization
- Clinic/Center
- Ambulatory Surgical
- CLIA Number: 03D0989609
- CLIA Cert. Type: Ambulatory Surgery Center
- CLIA Exp. Date: 07-30-2027
About HAVASU SURGERY CENTER
This page provides the complete NPI Profile along with additional information for Havasu Surgery Center, a provider established in Lake Havasu City, Arizona operating as a Clinic/center, focusing in ambulatory surgical . The healthcare provider is registered in the NPI registry with number 1386619484 assigned on February 2006. The practitioner's primary taxonomy code is 261QA1903X with license number OSC2912 (AZ). The provider is registered as an organization and their NPI record was last updated 6 years ago. The provider's is doing business as Havasu Surgery Center. The authorized official of this NPI record is William M. Gracey (Coo)
- NPI
- 1386619484
- Provider Legal Name
- HAVASU SURGERY CENTER
- Other Organization Name
- HAVASU SURGERY CENTER
- Other Name Type
- Doing Business As (3)
- Entity Type
- Organization
- Location Address
- 1775 MCCULLOCH BLVD LAKE HAVASU CITY, AZ 86403
- Location Phone
- (928) 453-4200
- Location Fax
- (928) 453-8271
- Mailing Address
- 103 POWELL CT STE. 200 BRENTWOOD, TN 37027
- Mailing Phone
- (615) 372-8500
- Mailing Fax
- (928) 453-8271
- Is Sole Proprietor?
- No
- Is Organization Subpart?
- No
- Enumeration Date
- 02-22-2006
- Last Update Date
- 08-22-2020
- 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 Ambulatory Surgical
- Taxonomy Code
- 261QA1903X
- Type
- Ambulatory Health Care Facilities
- License No.
- OSC2912
- License State
- AZ
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
- 03D0989609
- Facility Type
- Ambulatory Surgery Center
- Certificate Effective Date
- July 31, 2025
- Certificate Expiration Date
- July 30, 2027
- Laboratory Director
- MANDEEP POWAR MD
- Certificate Type
- Certificate of Waiver
- Certificate Type Description
- This CLIA certificate is issued to Havasu Surgery Center to perform only waived tests. CLIA defines waived tests as simple tests with a low risk for an incorrect result. Waived tests include certain tests listed in CLIA regulations, tests cleared by the FDA for home use and tests approved by the FDA for waived status and that meet CLIA waiver criteria.
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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 1386619484, we treat the final digit (4) 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 66. The final step is to find the difference between that total and the next multiple of ten (70 - 66 = 4).
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 66 is 70. The difference is the calculated check digit.
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1386619484, enumerated as an "organization" on February 22, 2006.
The provider is located at 1775 MCCULLOCH BLVD LAKE HAVASU CITY, AZ 86403 and the phone number is (928) 453-4200.
Clinic/Center with taxonomy code 261QA1903X and a focus in Ambulatory Surgical.
