03D1082429 CLIA NUMBER - ARIZONA WOMENS SPECIALISTS MARYVALE MEDICAL CENTER

Laboratory Demographics

CLIA Number: 03D1082429

Facility Name: ARIZONA WOMENS SPECIALISTS MARYVALE MEDICAL CENTER

Facility Address:
4700 N 51ST AVE, SUITE 5
PHOENIX, AZ
ZIP 85031
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Facility Phone Number: 623 846-7597

Facility Type: Physician Office

Certificate Type: Waiver

NPI Number: 1437189404

Taxonomy: 207V00000X - Obstetrics & Gynecology
An obstetrician/gynecologist possesses special knowledge, skills and professional capability in the medical and surgical care of the female reproductive system and associated disorders. This physician serves as a consultant to other physicians and as a primary physician for women.

CLIA Record

Field Name	Field Value
CLIA Number	03D1082429
LAB Type	Physician Office
Facility Name	ARIZONA WOMENS SPECIALISTS MARYVALE MEDICAL CENTER
Street	4700 N 51ST AVE, SUITE 5
City	PHOENIX
State	AZ
ZIP	85031
Phone	623 846-7597
CertificateType	4
CertificateEffectiveDate	4/9/2024
CertificateExpirationDate	4/8/2026
FacilityType	Waiver

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