03D2104914 CLIA NUMBER - CHICANOS POR LA CAUSA - CENTRO DE LE FAMILIA

Laboratory Demographics

CLIA Number: 03D2104914

Facility Name: CHICANOS POR LA CAUSA - CENTRO DE LE FAMILIA

Facility Address:
6850 W INDIAN SCHOOL RD
PHOENIX, AZ
ZIP 85033
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Facility Phone Number: (623) 247-0464

Facility Type: OTHER

Certificate Type: Waiver

NPI Number: 1386294437

Taxonomy: 363LP0808X - Nurse Practitioner

CLIA Record

Field Name	Field Value
CLIA Number	03D2104914
LAB Type	OTHER
Facility Name	CHICANOS POR LA CAUSA - CENTRO DE LE FAMILIA
Street	6850 W INDIAN SCHOOL RD
City	PHOENIX
State	AZ
ZIP	85033
Phone	(623) 247-0464

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