03D2081862 CLIA NUMBER - ANTHEM PAIN MANAGEMENT

Laboratory Demographics

  • CLIA Code: 03D2081862
  • Facility Name: ANTHEM PAIN MANAGEMENT
  • Facility Address: 41818 N VENTURE DR, STE 150
    ANTHEM, AZ
    ZIP 85086
  • Facility Phone: 623 341-8469
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: KEITH R. SUTTON
  • NPI Number: 1972910990
  • Taxonomy: 302R00000X - Health Maintenance Organization

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CLIA Record

Field Name Field Value
CLIA Number 03D2081862
LAB Type Physician Office
Facility Name ANTHEM PAIN MANAGEMENT
Street 41818 N VENTURE DR, STE 150
City ANTHEM
State AZ
ZIP 85086
Phone 623 341-8469
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 7/31/2024
Certificate Expiration Date 7/30/2026
Facility Type Physician Office
Lab Director KEITH R. SUTTON

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This page was last updated on: 9/29/2025