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03D2085580 CLIA NUMBER - ST JOSEPH'S ADVANCED WOUND HEALING & HYPERBARIC MEDICINE CENTER

Laboratory Demographics

CLIA Number: 03D2085580

Facility Name: ST JOSEPH'S ADVANCED WOUND HEALING & HYPERBARIC MEDICINE CENTER

Facility Address:
124 W THOMAS RD, STE 103
PHOENIX, AZ
ZIP 85013
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Facility Phone Number: 602 406-4325

Facility Type: Community Clinic

Certificate Type: Waiver
NPI Number: 1992131734

Taxonomy: 282N00000X - General Acute Care Hospital
An acute general hospital is an institution whose primary function is to provide inpatient diagnostic and therapeutic services for a variety of medical conditions, both surgical and non-surgical, to a wide population group. The hospital treats patients in an acute phase of illness or injury, characterized by a single episode or a fairly short duration, from which the patient returns to his or her normal or previous level of activity.

CLIA Record

Field Name Field Value
CLIA Number 03D2085580
LAB Type Community Clinic
Facility Name ST JOSEPH'S ADVANCED WOUND HEALING & HYPERBARIC MEDICINE CENTER
Street 124 W THOMAS RD, STE 103
City PHOENIX
State AZ
ZIP 85013
Phone 602 406-4325
CertificateType 4
CertificateEffectiveDate 10/16/2022
CertificateExpirationDate 10/15/2024
FacilityType Waiver

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