03D2123430 CLIA NUMBER - Prototype Health, Inc

Laboratory Demographics

CLIA Number: 03D2123430

Facility Name: Prototype Health, Inc

Facility Address:
205 E Southern Ave, #103,
Mesa, AZ
ZIP 85210
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Facility Phone Number: (480) 999-1717

Facility Type: PHYSICIAN OFFICE

Certificate Type: Waiver

CLIA Record

Field Name Field Value
CLIA Number 03D2123430
LAB Type PHYSICIAN OFFICE
Facility Name Prototype Health, Inc
Street 205 E Southern Ave, #103,
City Mesa
State AZ
ZIP 85210
Phone 4809991717

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