03D2123348 CLIA NUMBER - Banner Urgent Care Services Llc

Laboratory Demographics

CLIA Number: 03D2123348

Facility Name: Banner Urgent Care Services Llc

Facility Address:
11685 W Van Buren,
Avondale, AZ
ZIP 85323
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Facility Phone Number: (623) 465-6420

Facility Type: OTHER

Certificate Type: Waiver

NPI Number: 1891267407
261QU0200X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	03D2123348
LAB Type	OTHER
Facility Name	Banner Urgent Care Services Llc
Street	11685 W Van Buren,
City	Avondale
State	AZ
ZIP	85323
Phone	6234656420

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