Healthcare Provider Details

I. General information

NPI: 1336051168
Provider Name (Legal Business Name): HEALTH CLINICAL LAB LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/17/2026
Last Update Date: 09/17/2026
Certification Date: 09/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6044 S 16TH ST STE 180
PHOENIX AZ
85042-4472
US

IV. Provider business mailing address

6044 S 16TH ST STE 180
PHOENIX AZ
85042-4472
US

V. Phone/Fax

Practice location:
  • Phone: 602-350-9547
  • Fax:
Mailing address:
  • Phone: 602-350-9547
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code291U00000X
TaxonomyClinical Medical Laboratory
License Number
License Number State

VIII. Authorized Official

Name: MIGUEL A DURAN
Title or Position: OWNER
Credential:
Phone: 602-350-9547