03D2129785 CLIA NUMBER - PALO VERDE HEMATOLOGY ONCOLOGY DBA

Laboratory Demographics

CLIA Number: 03D2129785

Facility Name: PALO VERDE HEMATOLOGY ONCOLOGY DBA

Facility Address:
519 ROSE LANE
WICKENBURG, AZ
ZIP 85390
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Facility Phone Number: (623) 547-2600

Facility Type: PHYSICIAN OFFICE

Certificate Type: Waiver

NPI Number: 1952007106

Taxonomy: 332900000X - Non-Pharmacy Dispensing Site
A site other than a pharmacy that dispenses medicinal preparations under the supervision of a physician to patients for self-administration. (e.g. physician offices, ER, Urgent Care Centers, Rural Health Facilities, etc.)

CLIA Record

Field Name	Field Value
CLIA Number	03D2129785
LAB Type	PHYSICIAN OFFICE
Facility Name	PALO VERDE HEMATOLOGY ONCOLOGY DBA
Street	519 ROSE LANE
City	WICKENBURG
State	AZ
ZIP	85390
Phone	(623) 547-2600

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