03D2149629 CLIA NUMBER - SOUTHWEST AMBULANCE OF SOUTHEASTERN ARIZONA

Laboratory Demographics

CLIA Number: 03D2149629

Facility Name: SOUTHWEST AMBULANCE OF SOUTHEASTERN ARIZONA

Facility Address:
1765 W THATCHER BLVD
SAFFORD, AZ
ZIP 85546
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Facility Phone Number: 480 257-1350

Facility Type: Ambulance

Certificate Type: Waiver

NPI Number: 1457381790

Taxonomy: 332B00000X - Durable Medical Equipment & Medical Supplies
A supplier of medical equipment such as respirators, wheelchairs, home dialysis systems, or monitoring systems, that are prescribed by a physician for a patient's use in the home and that are usable for an extended period of time.

CLIA Record

Field Name	Field Value
CLIA Number	03D2149629
LAB Type	Ambulance
Facility Name	SOUTHWEST AMBULANCE OF SOUTHEASTERN ARIZONA
Street	1765 W THATCHER BLVD
City	SAFFORD
State	AZ
ZIP	85546
Phone	480 257-1350
CertificateType	4
CertificateEffectiveDate	6/7/2022
CertificateExpirationDate	6/6/2024
FacilityType	Waiver

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