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General NPI Number Information
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NPI Number | 1750026472
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Entity Type | Organization
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Legal Business Name | VISITING HEARTS LABS
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Dates
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Enumeration Date | 04/28/2022
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Last Update Date | 04/28/2022
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Provider Practice Location Address
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Address Line | 11225 N 28TH DRIVE SUITE 102-12
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City | PHOENIX
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State | AZ
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Zip | 85029-2045
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Country | US
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Telephone | 480-770-6192
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Fax |
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Provider Business Mailing Address
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Address Line | 738 E FOOTHILL BLVD
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City | GLENDORA
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State | CA
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Zip | 91741-2714
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Country | US
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Telephone | 310-927-8751
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Fax |
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Authorized Official
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Title or Position | MANGER
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Name | SUZETTE JOHNSON
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Credential |
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Telephone | 310-927-8751
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 291U00000X
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Taxonomy Name | Clinical Medical Laboratory
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License Number |
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License Number State |
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