03D2121103 CLIA NUMBER - HEALTHY WINGS FAMILY & PSYCHIATRIC HEALTHCARE

Laboratory Demographics

CLIA Number: 03D2121103

Facility Name: HEALTHY WINGS FAMILY & PSYCHIATRIC HEALTHCARE

Facility Address:
2055 E SOUTHERN AVE STE B
TEMPE, AZ
ZIP 85282
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Facility Phone Number: (520) 477-1815

Facility Type: PHYSICIAN OFFICE

Certificate Type: Waiver

NPI Number: 1376905786

Taxonomy: 261QP2300X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	03D2121103
LAB Type	PHYSICIAN OFFICE
Facility Name	HEALTHY WINGS FAMILY & PSYCHIATRIC HEALTHCARE
Street	2055 E SOUTHERN AVE STE B
City	TEMPE
State	AZ
ZIP	85282
Phone	(520) 477-1815

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