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DIAGNOSTIC IMAGING NETWORK GLENDALE PET CT CENTER 403 South Glendale Ave. Glendale CA 91205 Phone: 8185461929 Fax: 8185461930Physicians Order Form Patient Name: Phone: Provider: Phone: Examination
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Indicate the type of diagnostic imaging you require, such as X-ray, MRI, CT scan, or ultrasound.
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USC Radiology Associates Diagnostic Imaging is a facility that provides various radiology services such as x-rays, MRIs, CT scans, and ultrasounds.
Medical professionals and facilities that perform diagnostic imaging services are required to file USC Radiology Associates Diagnostic Imaging.
To fill out USC Radiology Associates Diagnostic Imaging, the provider must include details such as patient information, type of procedure, date of service, and referring physician.
The purpose of USC Radiology Associates Diagnostic Imaging is to document and report diagnostic imaging services provided to patients for medical purposes.
Information such as patient demographics, procedure details, insurance information, and referring physician details must be reported on USC Radiology Associates Diagnostic Imaging.
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