03D1034731 CLIA NUMBER - BANNER URGENT CARE SERVICES LLC

Laboratory Demographics

CLIA Number: 03D1034731

Facility Name: BANNER URGENT CARE SERVICES LLC

Facility Address:
15223 N 87TH ST, #110
SCOTTSDALE, AZ
ZIP 85260
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Facility Phone Number: 480 682-4100

Facility Type: Physician Office

Certificate Type: Waiver

NPI Number: 1134749542

Taxonomy: 261QU0200X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	03D1034731
LAB Type	Physician Office
Facility Name	BANNER URGENT CARE SERVICES LLC
Street	15223 N 87TH ST, #110
City	SCOTTSDALE
State	AZ
ZIP	85260
Phone	480 682-4100
CertificateType	4
CertificateEffectiveDate	12/10/2022
CertificateExpirationDate	12/9/2024
FacilityType	Waiver

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