03D2106882 CLIA NUMBER - Summit Healthcare Outpatient Pavilion

Laboratory Demographics

CLIA Number: 03D2106882

Facility Name: Summit Healthcare Outpatient Pavilion

Facility Address:
4951 S White Mtn Blvd, Bldg A,
Show Low, AZ
ZIP 85901
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Facility Phone Number: (928) 537-6700

Facility Type: PHYSICIAN OFFICE

Certificate Type: Waiver

NPI Number: 1942701693

Taxonomy: 261QR1300X - Clinic/Center

CLIA Record

Field Name Field Value
CLIA Number 03D2106882
LAB Type PHYSICIAN OFFICE
Facility Name Summit Healthcare Outpatient Pavilion
Street 4951 S White Mtn Blvd, Bldg A,
City Show Low
State AZ
ZIP 85901
Phone (928) 537-6700

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