TRIDENT HEALTH CENTER
NPI 1902204191
Clinic/Center - Primary Care in Peoria, AZ
About Trident Health Center NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
TRIDENT HEALTH CENTER (NPI 1902204191) is a healthcare organization registered as a primary care in Peoria, Arizona and active in the NPI registry since December 2014. The organization holds a CLIA Waiver certificate valid through April 23, 2027 and lists Arvind Mahadevan, Medical Director, as its authorized official.
NPPES Registry Identity
Specialties & Licenses
Other Names 1
Other Identifiers 1
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 03D2094842
Trident Health Center · Peoria, AZOther Providers at the Same Location NPPES 2
Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.
PEORIA, AZ 85382
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 Trident Clinical PLLC's NPI number?
The NPI number for Trident Clinical PLLC is 1902204191. It was assigned to this organization in the NPPES registry on December 20, 2014. The provider is doing business as Trident Health Center.
Where is Trident Clinical PLLC located?
Trident Clinical PLLC is located at 20340 N Lake Pleasant Rd Ste 109, Peoria, AZ 85382. The listed phone number is (623) 299-9988.
What is Trident Clinical PLLC's specialty?
The primary specialty registered for this NPI is Clinic/Center, specializing in Primary Care, with taxonomy code 261QP2300X.
Does Trident Clinical PLLC hold a CLIA laboratory certificate?
Yes. A Certificate of Waiver (number 03D2094842) is associated with this NPI, valid through April 23, 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 Trident Clinical PLLC was last updated on October 27, 2016. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 9 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.
# Trident Health Center · NPI 1902204191
Primary Care organization in Peoria, Arizona. Organization record, active in the CMS NPPES registry since December 20, 2014.
## Identity
- **NPI:** 1902204191 (Entity type: Organization)
- **Enumerated:** December 20, 2014
- **Primary specialty:** Clinic/Center - Primary Care · taxonomy 261QP2300X
- **Legal business name:** Trident Clinical Pllc
- **Organization subpart:** No
- **Authorized official:** Arvind Mahadevan, MEDICAL DIRECTOR
## Practice location
- **Address:** 20340 N LAKE PLEASANT RD STE 109, Peoria, AZ 85382-9713
- **Phone:** (623) 299-9988
## Record status
- **NPPES last updated:** October 27, 2016
- **Other identifiers:** Medicare PIN Z125634 (AZ)
- **CLIA laboratory certificates:** 1 on file
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Source: [NPI Profile](https://npiprofile.com/npi/1902204191) · Data from the CMS NPPES public registry.