Community Bridges, Inc
Organization Active NPI Clinical Medical Laboratory · Globe, AZ
NPI 1821345752 · NPPES record last updated Aug 9, 2012
Key facts
- NPI
- 1821345752
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Clinical Medical Laboratory 291U00000X
- License
- 03D2036585 (AZ)
- Legal business name
- COMMUNITY BRIDGES, INC
- Practice address
- 5734 East Hope Lane
Globe, AZ 85501 - Phone
- (928) 425-2415
- Fax
- (928) 425-2464
- NPI assigned
- Aug 9, 2012
- Organization subpart
- Yes
- Parent organization (as reported)
- COMMUNITY BRIDGES, INC
Authorized official
- Name
- Mr. John Hogeboom, LISAC
- Title
- VP/Coo
- Phone
- (480) 831-7566
Corporate family (same tax ID) 24
Laboratory certificates & supplier records
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 03D2036585 | Community Bridges, Inc | Certificate of waiver | Feb 8, 2028 |
National Provider Directory
- Tax ID family
- Community Bridges Inc
- Part of
- Community Bridges Inc
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Medical Laboratory | 291U00000X | 03D2036585 | AZ | Yes |
Addresses
Primary practice location
5734 East Hope Lane
Globe, AZ 85501
Mailing address
1855 W Baseline Rd
Suite 101
Mesa, AZ 85202-9000
Phone (480) 831-7566
Other names
- Globe SRU & Outpatient Clinic
Other providers in Globe, AZ
- Cobre Valley Regional Medical Center
- Cobre Valley Regional Medical Center
- Cobre Valley Regional Medical Center
- Cobre Valley Regional Medical Center
- Community Bridges, Inc
- Complete Vision Care PLLC
- Concordia Oncology, PC
- Copper Giraffe PLLC
- Copper Mountain Inn, Inc.
- Copper State Home Health, LLC
All providers in Globe, AZ · Clinical Medical Laboratory in Arizona
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 9, 2012. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.