Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
JASON FORT, CST/CSA
Active Sole ProprietorJASON FORT, CST/CSA is a Medical Laboratory Technician healthcare provider located in SAN TAN VALLEY, Arizona. NPI 1417228909 is currently active in the NPPES registry. Verify at CMS.
Medical Laboratory Technician · SAN TAN VALLEY, AZ
Registration Details
- NPI Number
- 1417228909
- Provider Type
- Individual
- Gender
- Male
- NPI Issued
- Jan 16, 2012 (14.60682092581 yrs)
- Last Updated
- Aug 12, 2014
- Licenses
-
454110172 (OR)L18709787 (AZ)
- Sole Proprietor
- Yes
Practice Information
- Address
-
2778 E SUPERIOR RDSAN TAN VALLEY, AZ, 851434573Browse AZ providers · Browse ZIP 85143
- Phone
- 4803139045
- Fax
- 4809872186
- Primary Specialty
-
Medical Laboratory Technician
246ZS0410X
- Additional Specialty
- Medical Laboratory Technician
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.