03D0526658 CLIA NUMBER - MARYLAND GARDENS POST ACUTE

Laboratory Demographics

  • CLIA Code: 03D0526658
  • Facility Name: MARYLAND GARDENS POST ACUTE
  • Facility Address: 31 W MARYLAND AVE
    PHOENIX, AZ
    ZIP 85013
  • Facility Phone: 602 265-7484
  • Facility Type: Skilled Nursing Facility/Nursing Facility
  • Facility Type: Waiver
  • Lab Director: RANDOLPH AARON CLARK
  • NPI Number: 1942550645
  • Taxonomy: 314000000X - Skilled Nursing Facility

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CLIA Record

Field Name Field Value
CLIA Number 03D0526658
LAB Type Skilled Nursing Facility/Nursing Facility
Facility Name MARYLAND GARDENS POST ACUTE
Street 31 W MARYLAND AVE
City PHOENIX
State AZ
ZIP 85013
Phone 602 265-7484
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 9/1/2024
Certificate Expiration Date 8/31/2026
Facility Type Skilled Nursing Facility/Nursing Facility
Lab Director RANDOLPH AARON CLARK

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This page was last updated on: 9/29/2025