03D2106068 CLIA NUMBER - Four Peaks Healthcare Associates, Pllc

Laboratory Demographics

CLIA Number: 03D2106068

Facility Name: Four Peaks Healthcare Associates, Pllc

Facility Address:
1515 E Cedar Ave, Suite C1
Flagstaff, AZ
ZIP 86004
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Facility Phone Number: (928) 773-9714

Facility Type: OTHER PRACTITIONER

Certificate Type: Waiver

NPI Number: 1720450232

Taxonomy: 261QP2300X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	03D2106068
LAB Type	OTHER PRACTITIONER
Facility Name	Four Peaks Healthcare Associates, Pllc
Street	1515 E Cedar Ave, Suite C1
City	Flagstaff
State	AZ
ZIP	86004
Phone	(928) 773-9714

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