03D2123901 CLIA NUMBER - Banner Physician Specialists Arizona Llc

Laboratory Demographics

CLIA Number: 03D2123901

Facility Name: Banner Physician Specialists Arizona Llc

Facility Address:
37100 N Gantzel Rd Ste 201,
Queen Creek, AZ
ZIP 85140
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Facility Phone Number: (480) 394-4469

Facility Type: PHYSICIAN OFFICE

Certificate Type: Microscopy

NPI Number: 1316228802
261QM1300X - Clinic/Center

CLIA Record

Field Name Field Value
CLIA Number 03D2123901
LAB Type PHYSICIAN OFFICE
Facility Name Banner Physician Specialists Arizona Llc
Street 37100 N Gantzel Rd Ste 201,
City Queen Creek
State AZ
ZIP 85140
Phone 4803944469

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