03D2272964 CLIA NUMBER - SCOTTSDALE PAIN CENTER LLC

Laboratory Demographics

CLIA Number: 03D2272964

Facility Name: SCOTTSDALE PAIN CENTER LLC

Facility Address:
7010 E CHAUNCEY LN STE 215
PHOENIX, AZ
ZIP 85054
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Facility Phone Number: 480 314-2288

Facility Type: Other - OUTPATIENT TREATMENT

Certificate Type: Waiver

NPI Number: 1093434748

Taxonomy: 261Q00000X - Clinic/Center
A facility or distinct part of one used for the diagnosis and treatment of outpatients. Clinic/Center is irregularly defined, sometimes being limited to organizations serving specialized treatment requirements or distinct patient/client groups (e.g., radiology, poor, and public health).

CLIA Record

Field Name	Field Value
CLIA Number	03D2272964
LAB Type	Other - OUTPATIENT TREATMENT
Facility Name	SCOTTSDALE PAIN CENTER LLC
Street	7010 E CHAUNCEY LN STE 215
City	PHOENIX
State	AZ
ZIP	85054
Phone	480 314-2288
CertificateType	4
CertificateEffectiveDate	12/2/2022
CertificateExpirationDate	12/1/2024
FacilityType	Waiver

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