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03D2148789 CLIA NUMBER - ARIZONA INTEGRATED TELEPSYCHIATRY/TELEMEDICINE SERVICES

Laboratory Demographics

CLIA Number: 03D2148789

Facility Name: ARIZONA INTEGRATED TELEPSYCHIATRY/TELEMEDICINE SERVICES

Facility Address:
2735 E MAIN ST
MESA, AZ
ZIP 85213
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Facility Phone Number: 602 710-7011

Facility Type: Community Clinic

Certificate Type: Waiver
NPI Number: 1619299286

Taxonomy: 207R00000X - Internal Medicine
A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs.

CLIA Record

Field Name Field Value
CLIA Number 03D2148789
LAB Type Community Clinic
Facility Name ARIZONA INTEGRATED TELEPSYCHIATRY/TELEMEDICINE SERVICES
Street 2735 E MAIN ST
City MESA
State AZ
ZIP 85213
Phone 602 710-7011
CertificateType 4
CertificateEffectiveDate 5/18/2022
CertificateExpirationDate 5/17/2024
FacilityType Waiver

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