03D2191269 CLIA NUMBER - PEAK MEDICAL & WELLNESS CENTER

Home > CLIA Lookup > 03D2191269

Laboratory Demographics

CLIA Number: 03D2191269

Facility Name: PEAK MEDICAL & WELLNESS CENTER

Facility Address:
41810 N VENTURE DR SUITE E160
ANTHEM, AZ
ZIP 85086
Get Directions

Facility Phone Number: 623 233-0025

Facility Type: Practitioner Other

Certificate Type: Waiver

NPI Number: 1699149070

Taxonomy: 363LF0000X - Nurse Practitioner

CLIA Record

Field Name	Field Value
CLIA Number	03D2191269
LAB Type	Practitioner Other
Facility Name	PEAK MEDICAL & WELLNESS CENTER
Street	41810 N VENTURE DR SUITE E160
City	ANTHEM
State	AZ
ZIP	85086
Phone	623 233-0025
CertificateType	4
CertificateEffectiveDate	8/25/2022
CertificateExpirationDate	8/24/2024
FacilityType	Waiver

Download Record

Export to text format icon Download this CLIA NUMBER record in Text format: Export

Export to text format icon Download this CLIA NUMBER record in Excel (CSV) format: Export

Export to text format icon Download this CLIA NUMBER record in XML format: Export

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