Healthcare Provider Details

I. General information

NPI: 1134891195
Provider Name (Legal Business Name): CLINICAL STUDIES OF ARIZONA, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/29/2021
Last Update Date: 09/29/2021
Certification Date: 07/29/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2701 E THOMAS RD STE E
PHOENIX AZ
85016-8218
US

IV. Provider business mailing address

2701 E THOMAS RD STE E
PHOENIX AZ
85016-8218
US

V. Phone/Fax

Practice location:
  • Phone: 602-206-6649
  • Fax:
Mailing address:
  • Phone: 602-206-6649
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207SC0300X
TaxonomyClinical Cytogenetics Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code291U00000X
TaxonomyClinical Medical Laboratory
License Number
License Number State

VIII. Authorized Official

Name: LILIANA SCOTT
Title or Position: CEO
Credential:
Phone: 602-206-6649