03D2287473 CLIA NUMBER - PROSANO HEALTH SOLUTIONS

Laboratory Demographics

CLIA Number: 03D2287473

Facility Name: PROSANO HEALTH SOLUTIONS

Facility Address:
7373 N SCOTTSDALE RD STE A178
SCOTTSDALE, AZ
ZIP 85253
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Facility Phone Number: 855 776-7265

Facility Type: Physician Office

Certificate Type: Waiver

NPI Number: 1346027695

Taxonomy: 261QP2300X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	03D2287473
LAB Type	Physician Office
Facility Name	PROSANO HEALTH SOLUTIONS
Street	7373 N SCOTTSDALE RD STE A178
City	SCOTTSDALE
State	AZ
ZIP	85253
Phone	855 776-7265
CertificateType	4
CertificateEffectiveDate	8/15/2023
CertificateExpirationDate	8/14/2025
FacilityType	Waiver

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