03D2116238 CLIA NUMBER - DIVINE IV AND WELLNESS

Laboratory Demographics

CLIA Number: 03D2116238

Facility Name: DIVINE IV AND WELLNESS

Facility Address:
2231 E PECOS RD #4
CHANDLER, AZ
ZIP 85225
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Facility Phone Number: (480) 488-9058

Facility Type: OTHER PRACTITIONER

Certificate Type: Waiver

CLIA Record

Field Name	Field Value
CLIA Number	03D2116238
LAB Type	OTHER PRACTITIONER
Facility Name	DIVINE IV AND WELLNESS
Street	2231 E PECOS RD #4
City	CHANDLER
State	AZ
ZIP	85225
Phone	(480) 488-9058

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