03D1103845 CLIA NUMBER - DESERT GROVE FAMILY MEDICAL - QUEEN CREEK

Laboratory Demographics

CLIA Number: 03D1103845

Facility Name: DESERT GROVE FAMILY MEDICAL - QUEEN CREEK

Facility Address:
20928 E HERITAGE LOOP RD, STE 106
QUEEN CREEK, AZ
ZIP 85142
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Facility Phone Number: 480 834-7546

Facility Type: Physician Office

Certificate Type: Microscopy

NPI Number: 1093764938

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	03D1103845
LAB Type	Physician Office
Facility Name	DESERT GROVE FAMILY MEDICAL - QUEEN CREEK
Street	20928 E HERITAGE LOOP RD, STE 106
City	QUEEN CREEK
State	AZ
ZIP	85142
Phone	480 834-7546
CertificateType	3
CertificateEffectiveDate	8/19/2023
CertificateExpirationDate	8/18/2025
FacilityType	PPMP

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