ADVANCED METABOLIC TESTING LLC NPI 1700398682

NPI Information

NPI: 1700398682
Provider Name: ADVANCED METABOLIC TESTING LLC
Classification: Clinic/Center - 261QH0100X
Entity Type: Organization

Specialization: Health Service

CLIA Number: 03D2103490

Address:
1425 S GREENFIELD RD STE 101
MESA, AZ
ZIP 85206
Phone: (480) 981-3000
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ADVANCED METABOLIC TESTING LLC is a health service clinic center in Mesa, AZ. ADVANCED METABOLIC TESTING LLC NPI is 1700398682. The provider is registered as an organization entity type.

The provider's business location address is:

1425 S GREENFIELD RD STE 101
MESA, AZ
ZIP 85206-505
Phone: (480) 981-3000

The provider's authorized official is Anna Sparks .
The authorized official title is Owner and has the following contact phone number (480) 296-3621.

The CLIA number assigned to this NPI record is 03D2103490 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 10/31/2017 and was last updated on 3/17/2018.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	261QH0100X	Clinic/Center	Health Service			Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	1578088506	MEDICAID	ARIZONA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

NPI Synchronization or Removal

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