Az Lab, LLC
Allergy & Immunology, Allergy in Tempe, AZ. Organization (NPI-2).
NPI number1013376151
StatusActive
Last updated in NPPESFeb 17, 2016
Details
- NPI
- 1013376151
- Entity type
- Organization (NPI-2)
- Legal business name
- Az Lab, LLC
- Organization subpart
- No
- Enumeration date
- Feb 17, 2016
- Last updated
- Feb 17, 2016
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 207KA0200X | Allergy & Immunology, Allergy | 4476 | AZ | Yes |
| 207Q00000X | Family Medicine | 4476 | AZ | |
| 208D00000X | General Practice | 4476 | AZ |
Other names
- Corebella Allergy & Diagnostics (Doing Business As)
Practice location
2210 S Mill Ave8
Tempe, AZ 85282-2153
Phone 623-242-0346
Mailing address
2210 S Mill Ave8
Tempe, AZ 85282-2153
Phone 623-242-0346
Authorized official
Jonna Elaine Demore
Owner
6232420346
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