03D2100133 CLIA NUMBER - Modocurogyn, Pllc

Laboratory Demographics

CLIA Number: 03D2100133

Facility Name: Modocurogyn, Pllc

Facility Address:
9700 N 91st St, Ste A-103
Scottsdale, AZ
ZIP 85258
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Facility Phone Number: (480) 889-2654

Facility Type: PHYSICIAN OFFICE

Certificate Type: Waiver

NPI Number: 1538445812

Taxonomy: 174400000X - Specialist
An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree.

CLIA Record

Field Name Field Value
CLIA Number 03D2100133
LAB Type PHYSICIAN OFFICE
Facility Name Modocurogyn, Pllc
Street 9700 N 91st St, Ste A-103
City Scottsdale
State AZ
ZIP 85258
Phone (480) 889-2654

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This page was last updated on: 4/7/2021