03D2222230 CLIA NUMBER - CANYON PAIN AND SPINE

Laboratory Demographics

CLIA Number: 03D2222230

Facility Name: CANYON PAIN AND SPINE

Facility Address:
6320 W UNION HILLS DR STE A270
GLENDALE, AZ
ZIP 85308
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Facility Phone Number: 623 250-5288

Facility Type: Physician Office

Certificate Type: Waiver

NPI Number: 1104590512

Taxonomy: 208VP0014X - Pain Medicine
Interventional Pain Medicine is the discipline of medicine devoted to the diagnosis and treatment of pain and related disorders principally with the application of interventional techniques in managing subacute, chronic, persistent, and intractable pain, independently or in conjunction with other modalities of treatment.

CLIA Record

Field Name	Field Value
CLIA Number	03D2222230
LAB Type	Physician Office
Facility Name	CANYON PAIN AND SPINE
Street	6320 W UNION HILLS DR STE A270
City	GLENDALE
State	AZ
ZIP	85308
Phone	623 250-5288
CertificateType	4
CertificateEffectiveDate	4/27/2023
CertificateExpirationDate	4/26/2025
FacilityType	Waiver

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