03D2232419 CLIA NUMBER - BANNER MD ANDERSON CANCER CENTER - POC TESTING

Laboratory Demographics

CLIA Number: 03D2232419

Facility Name: BANNER MD ANDERSON CANCER CENTER - POC TESTING

Facility Address:
2946 E BANNER GATEWAY DR
GILBERT, AZ
ZIP 85234
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Facility Phone Number: 480 256-3359

Facility Type: Physician Office

Certificate Type: Waiver

NPI Number: 1306231139

Taxonomy: 3336C0003X - Pharmacy
A pharmacy where pharmacists store, prepare, and dispense medicinal preparations and/or prescriptions for a local patient population in accordance with federal and state law; counsel patients and caregivers (sometimes independent of the dispensing process); administer vaccinations; and provide other professional services associated with pharmaceutical care such as health screenings, consultative services with other health care providers, collaborative practice, disease state management, and education classes.

CLIA Record

Field Name	Field Value
CLIA Number	03D2232419
LAB Type	Physician Office
Facility Name	BANNER MD ANDERSON CANCER CENTER - POC TESTING
Street	2946 E BANNER GATEWAY DR
City	GILBERT
State	AZ
ZIP	85234
Phone	480 256-3359
CertificateType	4
CertificateEffectiveDate	8/12/2023
CertificateExpirationDate	8/11/2025
FacilityType	Waiver

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