03D0713599 CLIA NUMBER - TRI-CITY COLO-RECTAL SURGERY

Laboratory Demographics

  • CLIA Code: 03D0713599
  • Facility Name: TRI-CITY COLO-RECTAL SURGERY
  • Facility Address: 2223 E BASELINE RD STE A
    GILBERT, AZ
    ZIP 85234
  • Facility Phone: 480 835-5302
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: K S VENKATESH
  • NPI Number: 1285771600
  • Taxonomy: 208C00000X - Colon & Rectal Surgery

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CLIA Record

Field Name Field Value
CLIA Number 03D0713599
LAB Type Physician Office
Facility Name TRI-CITY COLO-RECTAL SURGERY
Street 2223 E BASELINE RD STE A
City GILBERT
State AZ
ZIP 85234
Phone 480 835-5302
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 5/30/2024
Certificate Expiration Date 5/29/2026
Facility Type Physician Office
Lab Director K S VENKATESH

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