03D2128471 CLIA NUMBER - Active Life Physical Medicine & Pain C

Laboratory Demographics

CLIA Number: 03D2128471

Facility Name: Active Life Physical Medicine & Pain C

Facility Address:
15547 N Reems Rd, Bldg A
Surprise, AZ
ZIP 85374
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Facility Phone Number: (623) 535-9777

Facility Type: PHYSICIAN OFFICE

Certificate Type: Waiver

NPI Number: 1811130016

Taxonomy: 2081P2900X - Physical Medicine & Rehabilitation
A physician who provides a high level of care, either as a primary physician or consultant, for patients experiencing problems with acute, chronic or cancer pain in both hospital and ambulatory settings. Patient care needs may also be coordinated with other specialists.

CLIA Record

Field Name	Field Value
CLIA Number	03D2128471
LAB Type	PHYSICIAN OFFICE
Facility Name	Active Life Physical Medicine & Pain C
Street	15547 N Reems Rd, Bldg A
City	Surprise
State	AZ
ZIP	85374
Phone	(623) 535-9777

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