03D2008722 CLIA NUMBER - VALLEYWISE COMPREHENSIVE HEALTH CENTER

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Laboratory Demographics

CLIA Number: 03D2008722

Facility Name: VALLEYWISE COMPREHENSIVE HEALTH CENTER

Facility Address:
2525 E ROOSEVELT ST
PHOENIX, AZ
ZIP 85008
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Facility Phone Number: 602 344-5503

Facility Type: Hospital

Certificate Type: Microscopy

NPI Number: 1043679327

Taxonomy: 261QM0850X - Clinic/Center
An entity, facility, or distinct part of a facility providing diagnostic, treatment, and prescriptive services related to mental and behavioral disorders in adults.

CLIA Record

Field Name	Field Value
CLIA Number	03D2008722
LAB Type	Hospital
Facility Name	VALLEYWISE COMPREHENSIVE HEALTH CENTER
Street	2525 E ROOSEVELT ST
City	PHOENIX
State	AZ
ZIP	85008
Phone	602 344-5503
CertificateType	3
CertificateEffectiveDate	6/16/2022
CertificateExpirationDate	6/15/2024
FacilityType	PPMP

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