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03D2170075 CLIA NUMBER - ARIZONA ESSENTIAL HOLISTIC CARE, LLC

Laboratory Demographics

CLIA Number: 03D2170075

Facility Name: ARIZONA ESSENTIAL HOLISTIC CARE, LLC

Facility Address:
5700 W OLIVE AVE STE 102
GLENDALE, AZ
ZIP 85302
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Facility Phone Number: 623 738-6062

Facility Type: Physician Office

Certificate Type: Waiver
NPI Number: 1497246482

Taxonomy: 207Q00000X - Family Medicine
Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.

CLIA Record

Field Name Field Value
CLIA Number 03D2170075
LAB Type Physician Office
Facility Name ARIZONA ESSENTIAL HOLISTIC CARE, LLC
Street 5700 W OLIVE AVE STE 102
City GLENDALE
State AZ
ZIP 85302
Phone 623 738-6062
CertificateType 4
CertificateEffectiveDate 8/1/2023
CertificateExpirationDate 7/31/2025
FacilityType Waiver

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