03D2124795 CLIA NUMBER - SURPRISE ALC LLC DBA VINEYARD PARK OF SURPRISE

Laboratory Demographics

CLIA Number: 03D2124795

Facility Name: SURPRISE ALC LLC DBA VINEYARD PARK OF SURPRISE

Facility Address:
16650 N STADIUM WAY
SURPRISE, AZ
ZIP 85374
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Facility Phone Number: (623) 561-7728

Facility Type: ASSISTED LIVING FACILITY

Certificate Type: Waiver

CLIA Record

Field Name	Field Value
CLIA Number	03D2124795
LAB Type	ASSISTED LIVING FACILITY
Facility Name	SURPRISE ALC LLC DBA VINEYARD PARK OF SURPRISE
Street	16650 N STADIUM WAY
City	SURPRISE
State	AZ
ZIP	85374
Phone	(623) 561-7728

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This page was last updated on: 5/11/2023