HAVASU SURGERY CENTER
NPI 1386619484
Clinic/Center - Ambulatory Surgical in Lake Havasu City, AZ

Active since February 22, 2006CLIA 03D0989609 · Waiver
1775 MCCULLOCH BLVD, LAKE HAVASU CITY, AZ 86403(928) 453-4200(928) 453-8271 Get Directions Write a Review

NPPES record last updated: August 22, 2020. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Havasu Surgery Center NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

HAVASU SURGERY CENTER (NPI 1386619484) is a healthcare organization registered as an ambulatory surgical in Lake Havasu City, Arizona and active in the NPI registry since February 2006. The organization holds a CLIA Waiver certificate valid through July 30, 2027 and lists William M. Gracey, Coo, as its authorized official.

NPPES Registry Identity

NPI1386619484
Entity TypeOrganization
Primary Taxonomy261QA1903X
Legal Business NameHAVASU SURGERY CENTER
Location Address1775 MCCULLOCH BLVDLake Havasu City, AZ 86403
Mailing Address103 Powell Ct, Ste. 200Brentwood, TN 37027-5079 · (615) 372-8500 · Fax (615) 372-8572
Fax(928) 453-8271
Organization SubpartNo
Authorized OfficialWilliam M. GraceyCoo · (615) 372-8500
Enumeration DateFebruary 22, 2006
Last NPPES UpdateAugust 22, 2020
NPI 1386619484 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyClinic/Center · Ambulatory SurgicalAmbulatory Health Care Facilities
Taxonomy Code261QA1903X
License Licensed in AZ · OSC2912
1775 MCCULLOCH BLVD, Lake Havasu City, AZ 86403

Other Names 1

Doing Business AsHavasu Surgery Center

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 03D0989609

Havasu Surgery Center Inc · Lake Havasu City, AZ
Active · expires Jul 30, 2027
CLIA Number03D0989609
Laboratory TypeAmbulatory Surgery Center
Certificate Effective DateJuly 31, 2025
Certificate Expiration DateJuly 30, 2027
Laboratory DirectorMandeep Powar MD
Laboratory Phone(520) 453-4200
Laboratory LocationHavasu Surgery Center Inc1775 Mcculloch Blvd, Lake Havasu City, AZ 86403
CLIA data matches this NPI record on: Address Name
This certificate is issued to a laboratory to perform only waived tests.

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Havasu Surgery Center's NPI number?

The NPI number for Havasu Surgery Center is 1386619484. It was assigned to this organization in the NPPES registry on February 22, 2006.

Where is Havasu Surgery Center located?

Havasu Surgery Center is located at 1775 Mcculloch Blvd, Lake Havasu City, AZ 86403. The listed phone number is (928) 453-4200.

What is Havasu Surgery Center's specialty?

The primary specialty registered for this NPI is Clinic/Center, specializing in Ambulatory Surgical, with taxonomy code 261QA1903X.

Does Havasu Surgery Center hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 03D0989609) is associated with this NPI, valid through July 30, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Havasu Surgery Center was last updated on August 22, 2020. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.