03D2125165 CLIA NUMBER - GREATER PHOENIX COLLABORATIVE CARE, PC-GLENCROFT

Laboratory Demographics

CLIA Number: 03D2125165

Facility Name: GREATER PHOENIX COLLABORATIVE CARE, PC-GLENCROFT

Facility Address:
8641 N 67TH AVENUE
GLENDALE, AZ
ZIP 85302
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Facility Phone Number: (623) 869-5000

Facility Type: PHYSICIAN OFFICE

Certificate Type: Waiver

NPI Number: 1750686614

Taxonomy: 261Q00000X - Clinic/Center
A facility or distinct part of one used for the diagnosis and treatment of outpatients. Clinic/Center is irregularly defined, sometimes being limited to organizations serving specialized treatment requirements or distinct patient/client groups (e.g., radiology, poor, and public health).

CLIA Record

Field Name Field Value
CLIA Number 03D2125165
LAB Type PHYSICIAN OFFICE
Facility Name GREATER PHOENIX COLLABORATIVE CARE, PC-GLENCROFT
Street 8641 N 67TH AVENUE
City GLENDALE
State AZ
ZIP 85302
Phone (623) 869-5000

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