03D0529202 CLIA NUMBER - BROADWAY EAST INTERNISTS

Laboratory Demographics

  • CLIA Code: 03D0529202
  • Facility Name: BROADWAY EAST INTERNISTS
  • Facility Address: 7525 E BROADWAY RD SUITE 2
    MESA, AZ
    ZIP 85208
  • Facility Phone: 480 981-9800
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: ROBERT P. TULLY, MD
  • NPI Number: 1609523976
  • Taxonomy: 261Q00000X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 03D0529202
LAB Type Physician Office
Facility Name BROADWAY EAST INTERNISTS
Street 7525 E BROADWAY RD SUITE 2
City MESA
State AZ
ZIP 85208
Phone 480 981-9800
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 Physician Office
Lab Director ROBERT P. TULLY, MD

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