03D2112200 CLIA NUMBER - PHOENICIAN PRIMARY CARE

Laboratory Demographics

CLIA Number: 03D2112200

Facility Name: PHOENICIAN PRIMARY CARE

Facility Address:
2228 W NORTHERN AVE B202
PHOENIX, AZ
ZIP 85021
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Facility Phone Number: (480) 963-1853

Facility Type: PHYSICIAN OFFICE

Certificate Type: Waiver

NPI Number: 1972113546

Taxonomy: 207RC0000X - Internal Medicine
An internist who specializes in diseases of the heart and blood vessels and manages complex cardiac conditions such as heart attacks and life-threatening, abnormal heartbeat rhythms.

CLIA Record

Field Name	Field Value
CLIA Number	03D2112200
LAB Type	PHYSICIAN OFFICE
Facility Name	PHOENICIAN PRIMARY CARE
Street	2228 W NORTHERN AVE B202
City	PHOENIX
State	AZ
ZIP	85021
Phone	(480) 963-1853

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