Organization
WATERFORD DX LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. FRANK AFFINITO (OWNER)
(310) 503-9177
Entity
Organization
Contact information
Practice address
6830 N 55TH AVE STE 100, GLENDALE, AZ 85301-3304
(602) 774-2097
Mailing address
6830 N 55TH AVE STE 100, GLENDALE, AZ 85301-3304
(602) 774-2097
Taxonomy
Speciality
Code
Description
License number
State
291U00000X
Clinical Medical Laboratory
Primary
—
—
Other
Enumeration date
02/08/2024
Last updated
12/26/2024
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