03D0872628 CLIA NUMBER - VILLAGE MEDICAL PHOENIX CENTRAL

Laboratory Demographics

  • CLIA Code: 03D0872628
  • Facility Name: VILLAGE MEDICAL PHOENIX CENTRAL
  • Facility Address: 345 E VIRGINIA AVE
    PHOENIX, AZ
    ZIP 85004
  • Facility Phone: 602 258-5545
  • Facility Type: Physician Office
  • Facility Type: Microscopy
  • Lab Director: FRANK A. AGNONE
  • NPI Number: 1013318971
  • Taxonomy: 363LF0000X - Nurse Practitioner

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CLIA Record

Field Name Field Value
CLIA Number 03D0872628
LAB Type Physician Office
Facility Name VILLAGE MEDICAL PHOENIX CENTRAL
Street 345 E VIRGINIA AVE
City PHOENIX
State AZ
ZIP 85004
Phone 602 258-5545
Certificate Type Certificate for Provider-Performed Microscopy Procedures (PPMP)
Certificate Type Description This certificate is issued to a laboratory in which a physician, midlevel practitioner or dentist performs no tests other than the microscopy procedures. This certificate permits the laboratory to also perform waived tests.
Certificate Effective Date 7/1/2025
Certificate Expiration Date 6/30/2027
Facility Type Physician Office
Lab Director FRANK A. AGNONE

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