03D2013854 CLIA NUMBER - ADVANCED SPINE AND PAIN LLC

Home > CLIA Lookup > 03D2013854

Laboratory Demographics

CLIA Number: 03D2013854

Facility Name: ADVANCED SPINE AND PAIN LLC

Facility Address:
2563 S VAL VISTA DR, STE 101
GILBERT, AZ
ZIP 85295
Get Directions

Facility Phone Number: 480 573-0130

Facility Type: Ambulatory Surgery Center

Certificate Type: Waiver

NPI Number: 1689100299

Taxonomy: 261QA1903X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	03D2013854
LAB Type	Ambulatory Surgery Center
Facility Name	ADVANCED SPINE AND PAIN LLC
Street	2563 S VAL VISTA DR, STE 101
City	GILBERT
State	AZ
ZIP	85295
Phone	480 573-0130
CertificateType	4
CertificateEffectiveDate	9/24/2022
CertificateExpirationDate	9/23/2024
FacilityType	Waiver

Download Record

Export to text format icon Download this CLIA NUMBER record in Text format: Export

Export to text format icon Download this CLIA NUMBER record in Excel (CSV) format: Export

Export to text format icon Download this CLIA NUMBER record in XML format: Export

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