Organization
SUN LIFE FAMILY HEALTH CENTER, INC.
Active
Other names
Sun Life Family Health Center
Organization subpart
No
Provider details
NPI number
Authorized official
TRAVIS ROBINETTE (CHIEF EXECUTIVE OFFICER)
(520) 836-3446
Entity
Organization
Contact information
Practice address
865 N ARIZOLA RD, CASA GRANDE, AZ 85122-6011
(520) 836-3446
(520) 836-8807
Mailing address
PO BOX 10097, CASA GRANDE, AZ 85130-0020
(520) 836-3446
(520) 836-8807
Taxonomy
Speciality
Code
Description
License number
State
291U00000X
Clinical Medical Laboratory
Primary
03D0667661
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
03D0667661
CLIA WAIVER
—
Enumeration date
02/11/2014
Last updated
08/03/2017
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