03D2311970 CLIA NUMBER - AGAPE FAMILY WELLNESS

Laboratory Demographics

  • CLIA Code: 03D2311970
  • Facility Name: AGAPE FAMILY WELLNESS
  • Facility Address: 640 W MARYLAND AVE STE 4
    PHOENIX, AZ
    ZIP 85013
  • Facility Phone: 602 795-8122
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: RONDA SLICKMAN
  • NPI Number: 1801658117
  • Taxonomy: 261Q00000X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 03D2311970
LAB Type Physician Office
Facility Name AGAPE FAMILY WELLNESS
Street 640 W MARYLAND AVE STE 4
City PHOENIX
State AZ
ZIP 85013
Phone 602 795-8122
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 10/2/2024
Certificate Expiration Date 10/1/2026
Facility Type Physician Office
Lab Director RONDA SLICKMAN

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This page was last updated on: 9/29/2025