BANNER OCCUPATIONAL HEALTH ARIZONA LLC
NPI 1649813445
Clinic/Center - Occupational Medicine in Glendale, AZ
- Organization
- Clinic/Center
- Occupational Medicine
- CLIA Number: 03D2300891
- CLIA Cert. Type: Physician Office
- CLIA Exp. Date: 03-17-2026
About BANNER OCCUPATIONAL HEALTH ARIZONA LLC
This page provides the complete NPI Profile along with additional information for Banner Occupational Health Arizona Llc, a provider established in Glendale, Arizona operating as a Clinic/center, focusing in occupational medicine . The healthcare provider is registered in the NPI registry with number 1649813445 assigned on October 2019. The practitioner's primary taxonomy code is 261QX0100X. The provider is registered as an organization and their NPI record was last updated 7 years ago. The authorized official of this NPI record is Dennis Laraway (Cfo)
- NPI
- 1649813445 Verify this NPI
- Provider Name
- BANNER OCCUPATIONAL HEALTH ARIZONA LLC
- Entity Type
- Organization
- Location Address
- 5601 W EUGIE AVE STE 213 GLENDALE, AZ 85304
- Location Phone
- (602) 865-5618
- Mailing Address
- 2901 N CENTRAL AVE STE 160 PHOENIX, AZ 85012
- Is Sole Proprietor?
- No
- Is Organization Subpart?
- Yes
- Enumeration Date
- 10-24-2019
- Last Update Date
- 10-24-2019
- Code Navigator
Location Map
Specialty - Primary Taxonomy
The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.
- Classification
Clinic/Center Occupational Medicine
- Taxonomy Code
- 261QX0100X
- Type
- Ambulatory Health Care Facilities
CLIA Information
The Clinical Laboratory Improvement Amendments (CLIA) of 1988 applies to facilities or sites that test human specimens for health assessment or to diagnose, prevent, or treat disease. The CLIA Program sets standards for clinical laboratory testing and issues certificates. The NPI / CLIA crosswalk information for this NPI number is:
- CLIA Number
- 03D2300891
- Facility Type
- Physician Office
- Certificate Effective Date
- March 18, 2024
- Certificate Expiration Date
- March 17, 2026
- Laboratory Director
- RON TEICHMAN
- Certificate Type
- Certificate of Waiver
- Certificate Type Description
- This CLIA certificate is issued to Banner Occupational Health Arizona Llc to perform only waived tests. CLIA defines waived tests as simple tests with a low risk for an incorrect result. Waived tests include certain tests listed in CLIA regulations, tests cleared by the FDA for home use and tests approved by the FDA for waived status and that meet CLIA waiver criteria.
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Other Providers at the Same Location
The following 1 provider is registered at the same or a nearby location.
GLENDALE, AZ 85304
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1649813445, enumerated as an "organization" on October 24, 2019.
The provider is located at 5601 W EUGIE AVE STE 213 GLENDALE, AZ 85304 and the phone number is (602) 865-5618.
Clinic/Center with taxonomy code 261QX0100X and a focus in Occupational Medicine.
