03D0888363 CLIA NUMBER - SOUTHWEST KIDNEY INSTITUTE

Laboratory Demographics

  • CLIA Code: 03D0888363
  • Facility Name: SOUTHWEST KIDNEY INSTITUTE
  • Facility Address: 301 S POWER RD, STE 103
    MESA, AZ
    ZIP 85206
  • Facility Phone: 480 610-6100
  • Facility Type: Physician Office
  • Facility Type: Microscopy
  • Lab Director: FREDRICK V. OSORIO
  • NPI Number: 1659316008
  • Taxonomy: 207RN0300X - Internal Medicine

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CLIA Record

Field Name Field Value
CLIA Number 03D0888363
LAB Type Physician Office
Facility Name SOUTHWEST KIDNEY INSTITUTE
Street 301 S POWER RD, STE 103
City MESA
State AZ
ZIP 85206
Phone 480 610-6100
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 7/1/2024
Certificate Expiration Date 6/30/2026
Facility Type Physician Office
Lab Director FREDRICK V. OSORIO

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This page was last updated on: 3/20/2025