03D0928912 CLIA NUMBER - GERIATRIC SPECIALTIES OF ARIZONA PC

Laboratory Demographics

CLIA Number: 03D0928912

Facility Name: GERIATRIC SPECIALTIES OF ARIZONA PC

Facility Address:
6838 N 23RD AVE
PHOENIX, AZ
ZIP 85015
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Facility Phone Number: 602 864-8800

Facility Type: Physician Office

Certificate Type: Microscopy

NPI Number: 1649690603

Taxonomy: 332900000X - Non-Pharmacy Dispensing Site
A site other than a pharmacy that dispenses medicinal preparations under the supervision of a physician to patients for self-administration. (e.g. physician offices, ER, Urgent Care Centers, Rural Health Facilities, etc.)

CLIA Record

Field Name	Field Value
CLIA Number	03D0928912
LAB Type	Physician Office
Facility Name	GERIATRIC SPECIALTIES OF ARIZONA PC
Street	6838 N 23RD AVE
City	PHOENIX
State	AZ
ZIP	85015
Phone	602 864-8800
CertificateType	3
CertificateEffectiveDate	5/29/2023
CertificateExpirationDate	5/28/2025
FacilityType	PPMP

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