03D0057396 CLIA NUMBER - EVERNORTH CARE GROUP STAPLEY URGENT CARE STAT LABORATORY

Laboratory Demographics

CLIA Number: 03D0057396

Facility Name: EVERNORTH CARE GROUP STAPLEY URGENT CARE STAT LABORATORY

Facility Address:
1840 S STAPLEY DR STE 101
MESA, AZ
ZIP 85204
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Facility Phone Number: 602 861-7239

Facility Type: Other

Certificate Type: Certificate of Compliance

NPI Number: 1467564302

Taxonomy: 261QU0200X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	03D0057396
LAB Type	Other
Facility Name	EVERNORTH CARE GROUP STAPLEY URGENT CARE STAT LABORATORY
Street	1840 S STAPLEY DR STE 101
City	MESA
State	AZ
ZIP	85204
Phone	602 861-7239
CertificateType	2
CertificateEffectiveDate	2/15/2023
CertificateExpirationDate	2/14/2025
FacilityType	Compliance

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This page was last updated on: 4/23/2024