MEDICARE: ALLIANCE MEDICAL LABORATORY, LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	291U00000X	Clinical Medical Laboratory		AZ

General Provider Information

NPI Number	:	1841290806
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ALLIANCE MEDICAL LABORATORY, LLC

Provider Business Mailing Address
First Line	:	1764 E ROUTE 66
Second Line	:
City	:	FLAGSTAFF
State	:	AZ
Zip	:	86004-5139
Country	:	US
Telephone Number	:	928-773-2575
Fax Number	:	928-214-2680

Provider Business Practice Location Address
First Line	:	1764 E ROUTE 66
Second Line	:
City	:	FLAGSTAFF
State	:	AZ
Zip	:	86004-5139
Country	:	US
Telephone Number	:	928-773-2575
Fax Number	:	928-214-2680

Authorized Official
Title or Position	:	CEO
Name	:	MR. JAMES A. PUFFENBERGER
Credential	:
Telephone Number	:	928-779-3366

Provider Enumeration Date	:	07/29/2005
Last Update Date	:	08/22/2020

Similar Medicare Providers

1346323011 — LABORATORY CORPORATION OF AMERICA
Practice Location Address:

1764 E ROUTE 66
FLAGSTAFF, AZ
86004-5139

Practice Phone: 928-773-2575
Practice Fax:

1982551651 — ELK RIDGE FLAGSTAFF PHARMACY
Practice Location Address:

2920 N 4TH ST
FLAGSTAFF, AZ
86004-1816

Practice Phone: 520-670-3909
Practice Fax:

1912854696 — EL RIO SANTA CRUZ NEIGHBORHOOD HEALTH CENTER
Practice Location Address:

2920 N 4TH ST
FLAGSTAFF, AZ
86004-1816

Practice Phone: 520-670-3909
Practice Fax: 520-309-2560

1003579384 — KATELYNNE KETCHUM RBT
Practice Location Address:

3480 E ROUTE 66
FLAGSTAFF, AZ
86004-4032

Practice Phone: 928-438-9985
Practice Fax: 317-520-8200

1720890577 — CHA AZ LLC
Practice Location Address:

2109 E CEDAR AVE
FLAGSTAFF, AZ
86004-1920

Practice Phone: 303-808-5566
Practice Fax:

1528165321 — ANNAMARIE KHOURY CNP
Practice Location Address:

2920 N 4TH ST
FLAGSTAFF, AZ
86004-1816

Practice Phone: 928-213-6100
Practice Fax:

Directions to “ALLIANCE MEDICAL LABORATORY, LLC ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.