03D2113425 CLIA NUMBER - SURPRISE MEMORY CARE

Laboratory Demographics

CLIA Number: 03D2113425

Facility Name: SURPRISE MEMORY CARE

Facility Address:
16465 N PARKVIEW PLACE
SURPRISE, AZ
ZIP 85374
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Facility Phone Number: (623) 266-4999

Facility Type: ASSISTED LIVING FACILITY

Certificate Type: Waiver

NPI Number: 1114462330

Taxonomy: 261QD0000X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	03D2113425
LAB Type	ASSISTED LIVING FACILITY
Facility Name	SURPRISE MEMORY CARE
Street	16465 N PARKVIEW PLACE
City	SURPRISE
State	AZ
ZIP	85374
Phone	(623) 266-4999

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