03D0937823 CLIA NUMBER - BANNER CHILDREN'S - BANNER HEALTH CLINIC

Laboratory Demographics

  • CLIA Code: 03D0937823
  • Facility Name: BANNER CHILDREN'S - BANNER HEALTH CLINIC
  • Facility Address: 1450 S DOBSON STE B220
    MESA, AZ
    ZIP 85202
  • Facility Phone: 480 827-5044
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: KELLY ENGLAND
  • NPI Number: 1679941637
  • Taxonomy: 282NC2000X - General Acute Care Hospital

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CLIA Record

Field Name Field Value
CLIA Number 03D0937823
LAB Type Physician Office
Facility Name BANNER CHILDREN'S - BANNER HEALTH CLINIC
Street 1450 S DOBSON STE B220
City MESA
State AZ
ZIP 85202
Phone 480 827-5044
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 1/16/2024
Certificate Expiration Date 1/15/2026
Facility Type Physician Office
Lab Director KELLY ENGLAND

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