03D1036310 CLIA NUMBER - GREEN VALLEY FIRE DISTRICT

Laboratory Demographics

CLIA Number: 03D1036310

Facility Name: GREEN VALLEY FIRE DISTRICT

Facility Address:
1285 W CAMINO ENCANTO
GREEN VALLEY, AZ
ZIP 85622
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Facility Phone Number: 520 625-9400

Facility Type: Other

Certificate Type: Waiver

NPI Number: 1477953891

Taxonomy: 363LF0000X - Nurse Practitioner

CLIA Record

Field Name	Field Value
CLIA Number	03D1036310
LAB Type	Other
Facility Name	GREEN VALLEY FIRE DISTRICT
Street	1285 W CAMINO ENCANTO
City	GREEN VALLEY
State	AZ
ZIP	85622
Phone	520 625-9400
CertificateType	4
CertificateEffectiveDate	1/25/2023
CertificateExpirationDate	1/24/2025
FacilityType	Waiver

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