03D2273737 CLIA NUMBER - CALLED TO CARE GROUP RESIDENTIAL FACILITY LLC GH3

Laboratory Demographics

CLIA Number: 03D2273737

Facility Name: CALLED TO CARE GROUP RESIDENTIAL FACILITY LLC GH3

Facility Address:
1810 N 114TH AVE
AVONDALE, AZ
ZIP 85392
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Facility Phone Number: 602 885-7535

Facility Type: Other - NURSING SUPPORTED HOME

Certificate Type: Waiver

NPI Number: 1811359417

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	03D2273737
LAB Type	Other - NURSING SUPPORTED HOME
Facility Name	CALLED TO CARE GROUP RESIDENTIAL FACILITY LLC GH3
Street	1810 N 114TH AVE
City	AVONDALE
State	AZ
ZIP	85392
Phone	602 885-7535
CertificateType	4
CertificateEffectiveDate	12/19/2022
CertificateExpirationDate	12/18/2024
FacilityType	Waiver

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