NOVA VIA GLENDALE LLC
NPI 1801764212
Integrative Medicine in Glendale, AZ

Q: What is Nova Via Glendale LLC's NPI number?

The NPI number for Nova Via Glendale LLC is 1801764212. It was assigned to this organization in the NPPES registry on October 27, 2025.

Q: What is Nova Via Glendale LLC's specialty?

The primary specialty registered for this NPI is Integrative Medicine with taxonomy code 202D00000X.

Active since October 27, 2025CLIA 03D2337560 · Waiver

6830 N 55TH AVE, SUITE 100, GLENDALE, AZ 85301(480) 543-7432 Get Directions Write a Review

NPPES record last updated: October 27, 2025. Verified against the NPPES registry weekly; last sync: August 09, 2026.

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About Nova Via Glendale Llc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

NOVA VIA GLENDALE LLC (NPI 1801764212) is a healthcare organization registered as an integrative medicine in Glendale, Arizona and active in the NPI registry since October 2025. The organization holds a CLIA Waiver certificate valid through January 25, 2028 and lists Stephanie Jolly, Chief Compliance Officer, as its authorized official.

NPPES Registry Identity

NPI1801764212

Entity TypeOrganization

Primary Taxonomy202D00000X

Legal Business NameNOVA VIA GLENDALE LLC

Location Address6830 N 55TH AVE, SUITE 100Glendale, AZ 85301

Mailing Address6830 N 55th Ave, Suite 100Glendale, AZ 85301 · (480) 543-7432

Phone(480) 543-7432

Organization SubpartNo

Authorized OfficialStephanie JollyChief Compliance Officer · (480) 543-7432

Enumeration DateOctober 27, 2025

NPPES CertifiedOctober 27, 2025

✔ NPI 1801764212 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 14

★ Primary SpecialtyIntegrative MedicineAllopathic & Osteopathic Physicians

Taxonomy Code202D00000X

Definition

A physician who specializes in the treatment of the whole person through prevention and treatment based on medical evidence. Integrative medicine considers all factors that influence health, wellness, and disease – including mind, body, and spirit. Conventional and alternative methods are used to facilitate the body’s innate healing response. Appropriate consideration is given to use of less-invasive and less-harmful interventions, when possible. It also incorporates all appropriate therapeutic approaches, health care modalities, and disciplines to achieve optimal health and healing.

Also ListedCounselor · Addiction (Substance Use Disorder)Taxonomy 101YA0400X

Also ListedCounselor · Mental HealthTaxonomy 101YM0800X

Also ListedSocial WorkerTaxonomy 104100000X

Also ListedBehavior TechnicianTaxonomy 106S00000X

Also ListedChiropractorTaxonomy 111N00000X

Also ListedNutritionistTaxonomy 133N00000X

Also ListedRegistered NurseTaxonomy 163W00000X

Also ListedLicensed Practical NurseTaxonomy 164W00000X

Also ListedFamily Medicine · Addiction MedicineTaxonomy 207QA0401X

Also ListedFamily Medicine · Adult MedicineTaxonomy 207QA0505X

Also ListedPhysical Medicine & RehabilitationTaxonomy 208100000X

Also ListedPreventive Medicine · Addiction MedicineTaxonomy 2083A0300X

Also ListedCase ManagementTaxonomy 251B00000X

6830 N 55TH AVE, Glendale, AZ 85301

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Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 03D2337560

Nova Via Glendale LLC · Glendale, AZ

Active · expires Jan 25, 2028

CLIA Number03D2337560

Laboratory TypeComp. Outpatient Rehab Facility

Certificate Effective DateJanuary 26, 2026

Certificate Expiration DateJanuary 25, 2028

Laboratory DirectorAnnette Lusko

Laboratory Phone(623) 307-7716

Laboratory LocationNova Via Glendale LLC6830 N 55th Ave Ste 100B, Glendale, AZ 85301

CLIA data matches this NPI record on: Address Name

This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

DANIELLE DINER RN, BSN

Registered Nurse (Addiction (Substance Use Disorder))

6830 N 55TH AVE
GLENDALE, AZ 85301

Maricopa County (602) 718-7378

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Nova Via Glendale LLC's NPI number?

The NPI number for Nova Via Glendale LLC is 1801764212. It was assigned to this organization in the NPPES registry on October 27, 2025.

Where is Nova Via Glendale LLC located?

Nova Via Glendale LLC is located at 6830 N 55th Ave Suite 100, Glendale, AZ 85301. The listed phone number is (480) 543-7432.

What is Nova Via Glendale LLC's specialty?

The primary specialty registered for this NPI is Integrative Medicine with taxonomy code 202D00000X.

Does Nova Via Glendale LLC hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 03D2337560) is associated with this NPI, valid through January 25, 2028. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Nova Via Glendale LLC was last updated on October 27, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 9 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.