03D1009852 CLIA NUMBER - SUZANNE BENNETT, DO, PC

Laboratory Demographics

CLIA Number: 03D1009852

Facility Name: SUZANNE BENNETT, DO, PC

Facility Address:
18275 N 59TH AVE, BLDG H#144
GLENDALE, AZ
ZIP 85308
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Facility Phone Number: 602 843-2300

Facility Type: Physician Office

Certificate Type: Microscopy

NPI Number: 1881659936

Taxonomy: 208D00000X - General Practice
A physician who specializes in the general practice of diagnosing, treating, and managing patients with a variety of illnesses and conditions. Source: National Uniform Claim Committee

CLIA Record

Field Name	Field Value
CLIA Number	03D1009852
LAB Type	Physician Office
Facility Name	SUZANNE BENNETT, DO, PC
Street	18275 N 59TH AVE, BLDG H#144
City	GLENDALE
State	AZ
ZIP	85308
Phone	602 843-2300
CertificateType	3
CertificateEffectiveDate	2/27/2023
CertificateExpirationDate	2/26/2025
FacilityType	PPMP

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