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