03D2078143 CLIA NUMBER - SURGCENTER CAMELBACK, LLC

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Laboratory Demographics

CLIA Number: 03D2078143

Facility Name: SURGCENTER CAMELBACK, LLC

Facility Address:
6245 N 24TH PKWY, STE 112
PHOENIX, AZ
ZIP 85016
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Facility Phone Number: 602 510-3203

Facility Type: Ambulatory Surgery Center

Certificate Type: Waiver

NPI Number: 1407275282

Taxonomy: 261QA1903X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	03D2078143
LAB Type	Ambulatory Surgery Center
Facility Name	SURGCENTER CAMELBACK, LLC
Street	6245 N 24TH PKWY, STE 112
City	PHOENIX
State	AZ
ZIP	85016
Phone	602 510-3203
CertificateType	4
CertificateEffectiveDate	5/22/2022
CertificateExpirationDate	5/21/2024
FacilityType	Waiver

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