03D1021736 CLIA NUMBER - GRAYHAWK FAMILY PRACTICE

Laboratory Demographics

CLIA Number: 03D1021736

Facility Name: GRAYHAWK FAMILY PRACTICE

Facility Address:
10051 E DYNAMITE BLVD STE 110
SCOTTSDALE, AZ
ZIP 85262
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Facility Phone Number: 480 473-7003

Facility Type: Physician Office

Certificate Type: Waiver

NPI Number: 1013491166

Taxonomy: 207Q00000X - Family Medicine
Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.

CLIA Record

Field Name	Field Value
CLIA Number	03D1021736
LAB Type	Physician Office
Facility Name	GRAYHAWK FAMILY PRACTICE
Street	10051 E DYNAMITE BLVD STE 110
City	SCOTTSDALE
State	AZ
ZIP	85262
Phone	480 473-7003
CertificateType	4
CertificateEffectiveDate	11/1/2022
CertificateExpirationDate	10/31/2024
FacilityType	Waiver

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