03D2131145 CLIA NUMBER - Garnet Pain Relief Services LLC

Laboratory Demographics

CLIA Number: 03D2131145

Facility Name: Garnet Pain Relief Services LLC

Facility Address:
5659 White Mountain Blvd, Ste
Lakeside, AZ
ZIP 85929
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Facility Phone Number: (928) 358-1221

Facility Type: OTHER PRACTITIONER

Certificate Type: Waiver

NPI Number: 1750811816

Taxonomy: 261QP3300X - Clinic/Center

CLIA Record

Field Name Field Value
CLIA Number 03D2131145
LAB Type OTHER PRACTITIONER
Facility Name Garnet Pain Relief Services LLC
Street 5659 White Mountain Blvd, Ste
City Lakeside
State AZ
ZIP 85929
Phone (928) 358-1221

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