03D2123274 CLIA NUMBER - Pedersen Primary Care

Laboratory Demographics

CLIA Number: 03D2123274

Facility Name: Pedersen Primary Care

Facility Address:
5900 N Granite Reef Rd Suite 1
Scottsdale, AZ
ZIP 85260
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Facility Phone Number: (480) 659-5013

Facility Type: PHYSICIAN OFFICE

Certificate Type: Waiver

NPI Number: 1770027179

Taxonomy: 363LF0000X - Nurse Practitioner

CLIA Record

Field Name Field Value
CLIA Number 03D2123274
LAB Type PHYSICIAN OFFICE
Facility Name Pedersen Primary Care
Street 5900 N Granite Reef Rd Suite 1
City Scottsdale
State AZ
ZIP 85260
Phone (480) 659-5013

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This page was last updated on: 4/7/2021