03D2011360 CLIA NUMBER - GRACE ZLAKET-MATTA MD, LLC

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Laboratory Demographics

CLIA Number: 03D2011360

Facility Name: GRACE ZLAKET-MATTA MD, LLC

Facility Address:
9336 E RAINTREE DR, STE 150
SCOTTSDALE, AZ
ZIP 85260
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Facility Phone Number: 480 219-5597

Facility Type: Physician Office

Certificate Type: Waiver

NPI Number: 1679564512

Taxonomy: 207RE0101X - Internal Medicine
An internist who concentrates on disorders of the internal (endocrine) glands such as the thyroid and adrenal glands. This specialist also deals with disorders such as diabetes, metabolic and nutritional disorders, obesity, pituitary diseases and menstrual and sexual problems.

CLIA Record

Field Name	Field Value
CLIA Number	03D2011360
LAB Type	Physician Office
Facility Name	GRACE ZLAKET-MATTA MD, LLC
Street	9336 E RAINTREE DR, STE 150
City	SCOTTSDALE
State	AZ
ZIP	85260
Phone	480 219-5597
CertificateType	4
CertificateEffectiveDate	8/16/2022
CertificateExpirationDate	8/15/2024
FacilityType	Waiver

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