03D0867614 CLIA NUMBER - FORTY-THIRD MEDICAL ASSOCIATES, PC

Laboratory Demographics

CLIA Number: 03D0867614

Facility Name: FORTY-THIRD MEDICAL ASSOCIATES, PC

Facility Address:
7725 N 43RD AVENUE, STE 111
PHOENIX, AZ
ZIP 85051
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Facility Phone Number: 623 931-9201

Facility Type: Physician Office

Certificate Type: Microscopy

NPI Number: 1942607445

Taxonomy: 246XC2903X - Specialist/Technologist Cardiovascular

CLIA Record

Field Name	Field Value
CLIA Number	03D0867614
LAB Type	Physician Office
Facility Name	FORTY-THIRD MEDICAL ASSOCIATES, PC
Street	7725 N 43RD AVENUE, STE 111
City	PHOENIX
State	AZ
ZIP	85051
Phone	623 931-9201
CertificateType	3
CertificateEffectiveDate	9/1/2022
CertificateExpirationDate	8/31/2024
FacilityType	PPMP

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