03D2042992 CLIA NUMBER - BANNER URGENT CARE SERVICES LLC

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Laboratory Demographics

CLIA Number: 03D2042992

Facility Name: BANNER URGENT CARE SERVICES LLC

Facility Address:
3126 S HIGLEY RD, #109
GILBERT, AZ
ZIP 85296
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Facility Phone Number: 480 827-5780

Facility Type: Other - URGENT CARE

Certificate Type: Waiver

NPI Number: 1770055386

Taxonomy: 261QU0200X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	03D2042992
LAB Type	Other - URGENT CARE
Facility Name	BANNER URGENT CARE SERVICES LLC
Street	3126 S HIGLEY RD, #109
City	GILBERT
State	AZ
ZIP	85296
Phone	480 827-5780
CertificateType	4
CertificateEffectiveDate	6/25/2022
CertificateExpirationDate	6/24/2024
FacilityType	Waiver

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