Provider Demographics
NPI:1144615634
Name:ASSISTED REPRODUCTIVE LABS LLC
Entity Type:Organization
Organization Name:ASSISTED REPRODUCTIVE LABS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRACTICE ADMINISTRATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:RHODA
Authorized Official - Middle Name:M
Authorized Official - Last Name:RIZKALLA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:602-765-2229
Mailing Address - Street 1:9817 N 95TH ST
Mailing Address - Street 2:BLDG I, SUITE 105
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85258-4587
Mailing Address - Country:US
Mailing Address - Phone:602-765-2229
Mailing Address - Fax:602-493-6641
Practice Address - Street 1:9817 N 95TH ST
Practice Address - Street 2:BUILDING I, SUITE 105
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85258-4587
Practice Address - Country:US
Practice Address - Phone:602-765-2229
Practice Address - Fax:602-493-6641
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-04-01
Last Update Date:2015-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ03D0882062291U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory