03D2320412 CLIA NUMBER - ALLIANCE BEHAVIORAL HEALTH INTEGRATED

Laboratory Demographics

  • CLIA Code: 03D2320412
  • Facility Name: ALLIANCE BEHAVIORAL HEALTH INTEGRATED
  • Facility Address: 12801 W BELL RD STE 141
    SURPRISE, AZ
    ZIP 85378
  • Facility Phone: 623 401-2882
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: HORTENSE NOBLE
  • NPI Number: 1326852385
  • Taxonomy: 363LP0808X - Nurse Practitioner

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CLIA Record

Field Name Field Value
CLIA Number 03D2320412
LAB Type Physician Office
Facility Name ALLIANCE BEHAVIORAL HEALTH INTEGRATED
Street 12801 W BELL RD STE 141
City SURPRISE
State AZ
ZIP 85378
Phone 623 401-2882
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 3/18/2025
Certificate Expiration Date 3/17/2027
Facility Type Physician Office
Lab Director HORTENSE NOBLE

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