03D2105741 CLIA NUMBER - ALL WELLNESS MEDICAL CENTER, PLLC

Laboratory Demographics

CLIA Number: 03D2105741

Facility Name: ALL WELLNESS MEDICAL CENTER, PLLC

Facility Address:
2500 CANYON RD A2
BULLHEAD CITY, AZ
ZIP 86442
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Facility Phone Number: (928) 219-0719

Facility Type: PHYSICIAN OFFICE

Certificate Type: Waiver

NPI Number: 1154796969

Taxonomy: 261QP2300X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	03D2105741
LAB Type	PHYSICIAN OFFICE
Facility Name	ALL WELLNESS MEDICAL CENTER, PLLC
Street	2500 CANYON RD A2
City	BULLHEAD CITY
State	AZ
ZIP	86442
Phone	(928) 219-0719

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