03D0999336 CLIA NUMBER - GILA COUNTY SHERIFF'S OFFICE MEDICAL UNIT

Laboratory Demographics

CLIA Number: 03D0999336

Facility Name: GILA COUNTY SHERIFF'S OFFICE MEDICAL UNIT

Facility Address:
1100 S STREET
GLOBE, AZ
ZIP 85501
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Facility Phone Number: 928 402-0075

Facility Type: Other

Certificate Type: Waiver

NPI Number: 1073716791

Taxonomy: 2085R0202X - Radiology
A radiologist who utilizes x-ray, radionuclides, ultrasound and electromagnetic radiation to diagnose and treat disease.

CLIA Record

Field Name	Field Value
CLIA Number	03D0999336
LAB Type	Other
Facility Name	GILA COUNTY SHERIFF'S OFFICE MEDICAL UNIT
Street	1100 S STREET
City	GLOBE
State	AZ
ZIP	85501
Phone	928 402-0075
CertificateType	4
CertificateEffectiveDate	5/9/2024
CertificateExpirationDate	5/8/2026
FacilityType	Waiver

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