03D2126964 CLIA NUMBER - Cleanslate Centers

Laboratory Demographics

CLIA Number: 03D2126964

Facility Name: Cleanslate Centers

Facility Address:
7725 N 43rd Ave, #522
Phoenix, AZ
ZIP 85051
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Facility Phone Number: (413) 584-2173

Facility Type: PHYSICIAN OFFICE

Certificate Type: Waiver

NPI Number: 1326585662

Taxonomy: 207RA0401X - Internal Medicine
An internist doctor of osteopathy that specializes in the treatment of addiction disorders. A doctor of osteopathy that is board eligible/certified by the American Osteopathic Board of Internal Medicine can obtain a Certificate of Added Qualifications in the field of Addiction Medicine.

CLIA Record

Field Name Field Value
CLIA Number 03D2126964
LAB Type PHYSICIAN OFFICE
Facility Name Cleanslate Centers
Street 7725 N 43rd Ave, #522
City Phoenix
State AZ
ZIP 85051
Phone (413) 584-2173

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This page was last updated on: 4/7/2021