03D0664433 CLIA NUMBER - PHOENIX INDIAN MED CTR - LABORATORY

Laboratory Demographics

CLIA Number: 03D0664433

Facility Name: PHOENIX INDIAN MED CTR - LABORATORY

Facility Address:
4212 N 16TH ST
PHOENIX, AZ
ZIP 85016
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Facility Phone Number: 602 263-1698

Facility Type: Hospital

Certificate Type: Accreditation

NPI Number: 1427101377

Taxonomy: 163WC1500X - Registered Nurse

CLIA Record

Field Name	Field Value
CLIA Number	03D0664433
LAB Type	Hospital
Facility Name	PHOENIX INDIAN MED CTR - LABORATORY
Street	4212 N 16TH ST
City	PHOENIX
State	AZ
ZIP	85016
Phone	602 263-1698
CertificateType	1
CertificateEffectiveDate	2/9/2023
CertificateExpirationDate	2/8/2025
FacilityType	Accreditation

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This page was last updated on: 4/23/2024