03D1040477 CLIA NUMBER - SCOTTSDALE SPORTS MEDICINE INSTITUTE PC

Laboratory Demographics

CLIA Number: 03D1040477

Facility Name: SCOTTSDALE SPORTS MEDICINE INSTITUTE PC

Facility Address:
10133 N 92ND ST, STE #102
SCOTTSDALE, AZ
ZIP 85258
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Facility Phone Number: (480) 664-4615

Facility Type: PHYSICIAN OFFICE

Certificate Type: Waiver

NPI Number: 1023523396

Taxonomy: 261QD0000X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	03D1040477
LAB Type	PHYSICIAN OFFICE
Facility Name	SCOTTSDALE SPORTS MEDICINE INSTITUTE PC
Street	10133 N 92ND ST, STE #102
City	SCOTTSDALE
State	AZ
ZIP	85258
Phone	(480) 664-4615

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