03D2123274 CLIA NUMBER - Pedersen Primary Care

Laboratory Demographics

CLIA Number: 03D2123274

Facility Name: Pedersen Primary Care

Facility Address:
290 S Alma School Rd, Ste 5a,
Chandler, AZ
ZIP 85224
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Facility Phone Number: (480) 659-5013

Facility Type: PHYSICIAN OFFICE

Certificate Type: Waiver

NPI Number: 1770027179
363LF0000X - Nurse Practitioner

CLIA Record

Field Name Field Value
CLIA Number 03D2123274
LAB Type PHYSICIAN OFFICE
Facility Name Pedersen Primary Care
Street 290 S Alma School Rd, Ste 5a,
City Chandler
State AZ
ZIP 85224
Phone 4806595013

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This page was last updated on: 5/19/2019