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Community Bridges, Inc

Organization Active NPI Clinical Medical Laboratory · Avondale, AZ

NPI 1861768095 · NPPES record last updated Apr 2, 2012

Key facts

NPI
1861768095
Entity type
Organization (NPI type 2)
Primary specialty
Clinical Medical Laboratory 291U00000X
License
03D2036604 (AZ)
Legal business name
COMMUNITY BRIDGES, INC
Practice address
824 N 99TH Ave
Suite 108
Avondale, AZ 85323-5315
Phone
(623) 907-1457
NPI assigned
Apr 2, 2012
Organization subpart
Yes
Parent organization (as reported)
COMMUNITY BRIDGES, INC

Authorized official

Name
John Hogeboom, LISAC
Title
VP/Coo
Phone
(480) 831-7566

Corporate family (same tax ID) 22

Organizations that report the same tax identification number in the National Provider Directory.

Laboratory certificates & supplier records

Name & address match These CMS records do not include an NPI. They are shown here because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
03D2036604Community Bridges, Inc - West Valley Access Point
824 N 99TH Ave, Ste 107, Avondale, AZ 85323		Certificate of waiverFeb 8, 2028
03D2036608Community Bridges, Inc - West Valley Inpatient
824 N 99TH Ave Ste 109, Avondale, AZ 85323		Certificate of waiverFeb 8, 2028

National Provider Directory

Tax ID family
Community Bridges Inc (67 organizations share this tax ID)
Part of
Community Bridges Inc

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Medical Laboratory 291U00000X 03D2036604 AZ Yes

Addresses

Primary practice location

824 N 99TH Ave
Suite 108
Avondale, AZ 85323-5315

Mailing address

1855 W Baseline Rd
Suite 101
Mesa, AZ 85202-9000
Phone (480) 831-7566

Other names

  • West Valley Acces Point Doing business as

Other providers in Avondale, AZ

All providers in Avondale, AZ · Clinical Medical Laboratory in Arizona

Sources for this page

Verify at the official NPI Registry.