03D2134804 CLIA NUMBER - BENSON HOSPITAL FAMILY HEALTH CARE

Laboratory Demographics

CLIA Number: 03D2134804

Facility Name: BENSON HOSPITAL FAMILY HEALTH CARE

Facility Address:
688 W 4TH ST, STE B
BENSON, AZ
ZIP 85602
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Facility Phone Number: 520 720-6510

Facility Type: Community Clinic

Certificate Type: Waiver

NPI Number: 1336118322

Taxonomy: 282NC0060X - General Acute Care Hospital

CLIA Record

Field Name	Field Value
CLIA Number	03D2134804
LAB Type	Community Clinic
Facility Name	BENSON HOSPITAL FAMILY HEALTH CARE
Street	688 W 4TH ST, STE B
City	BENSON
State	AZ
ZIP	85602
Phone	520 720-6510
CertificateType	4
CertificateEffectiveDate	8/9/2023
CertificateExpirationDate	8/8/2025
FacilityType	Waiver

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This page was last updated on: 4/23/2024