03D2159344 CLIA NUMBER - SOUTHWESTERN EYE CENTER, LTD DBA M&M EYE INSTITUTE

Laboratory Demographics

CLIA Number: 03D2159344

Facility Name: SOUTHWESTERN EYE CENTER, LTD DBA M&M EYE INSTITUTE

Facility Address:
399 W PALOMINO ROAD
CHINO VALLEY, AZ
ZIP 86323
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Facility Phone Number: 928 636-5504

Facility Type: Physician Office

Certificate Type: Waiver

NPI Number: 1003384710

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	03D2159344
LAB Type	Physician Office
Facility Name	SOUTHWESTERN EYE CENTER, LTD DBA M&M EYE INSTITUTE
Street	399 W PALOMINO ROAD
City	CHINO VALLEY
State	AZ
ZIP	86323
Phone	928 636-5504
CertificateType	4
CertificateEffectiveDate	12/18/2022
CertificateExpirationDate	12/17/2024
FacilityType	Waiver

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