03D2111776 CLIA NUMBER - Banner-University Super Specialists Ll

Laboratory Demographics

CLIA Number: 03D2111776

Facility Name: Banner-University Super Specialists Ll

Facility Address:
755 E Mcdowell Rd
Phoenix, AZ
ZIP 85006
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Facility Phone Number: (844) 242-4664

Facility Type: PHYSICIAN OFFICE

Certificate Type: Waiver

NPI Number: 1619567922

Taxonomy: 261QS1200X - Clinic/Center

CLIA Record

Field Name Field Value
CLIA Number 03D2111776
LAB Type PHYSICIAN OFFICE
Facility Name Banner-University Super Specialists Ll
Street 755 E Mcdowell Rd
City Phoenix
State AZ
ZIP 85006
Phone (844) 242-4664

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