03D2103490 CLIA NUMBER - ADVANCED PAIN MANAGEMENT

Laboratory Demographics

CLIA Number: 03D2103490

Facility Name: ADVANCED PAIN MANAGEMENT

Facility Address:
4425 E AGAVE RD, BLDG 9, STE 152
PHOENIX, AZ
ZIP 85044
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Facility Phone Number: (623) 466-6350

Facility Type: PHYSICIAN OFFICE

Certificate Type: Waiver

NPI Number: 1700398682

Taxonomy: 261QH0100X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	03D2103490
LAB Type	PHYSICIAN OFFICE
Facility Name	ADVANCED PAIN MANAGEMENT
Street	4425 E AGAVE RD, BLDG 9, STE 152
City	PHOENIX
State	AZ
ZIP	85044
Phone	(623) 466-6350

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This page was last updated on: 5/11/2023