03D1005467 CLIA NUMBER - PHOENIX MEDICAL GROUP PC

Laboratory Demographics

CLIA Number: 03D1005467

Facility Name: PHOENIX MEDICAL GROUP PC

Facility Address:
14873 W BELL RD, STE 100
SURPRISE, AZ
ZIP 85374
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Facility Phone Number: (623) 815-7800

Facility Type: PHYSICIAN OFFICE

Certificate Type: Waiver

NPI Number: 1124251699

Taxonomy: 261QS1200X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	03D1005467
LAB Type	PHYSICIAN OFFICE
Facility Name	PHOENIX MEDICAL GROUP PC
Street	14873 W BELL RD, STE 100
City	SURPRISE
State	AZ
ZIP	85374
Phone	(623) 815-7800

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This page was last updated on: 5/11/2023