03D0930846 CLIA NUMBER - PINAL MOUNTAIN INTERNAL MEDICINE PC

Laboratory Demographics

  • CLIA Code: 03D0930846
  • Facility Name: PINAL MOUNTAIN INTERNAL MEDICINE PC
  • Facility Address: 5884 S HOSPITAL DRIVE #1
    GLOBE, AZ
    ZIP 85501
  • Facility Phone: 928 402-0096
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: BRENT J. LAYTON MD
  • NPI Number: 1487616157
  • Taxonomy: 207R00000X - Internal Medicine

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CLIA Record

Field Name Field Value
CLIA Number 03D0930846
LAB Type Physician Office
Facility Name PINAL MOUNTAIN INTERNAL MEDICINE PC
Street 5884 S HOSPITAL DRIVE #1
City GLOBE
State AZ
ZIP 85501
Phone 928 402-0096
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 7/18/2025
Certificate Expiration Date 7/17/2027
Facility Type Physician Office
Lab Director BRENT J. LAYTON MD

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