03D0952643 CLIA NUMBER - PRIME MEDICAL GROUP

Laboratory Demographics

  • CLIA Code: 03D0952643
  • Facility Name: PRIME MEDICAL GROUP
  • Facility Address: 652 E WARNER RD, STE 107
    GILBERT, AZ
    ZIP 85296
  • Facility Phone: 480 539-8680
  • Facility Type: Physician Office
  • Facility Type: Microscopy
  • Lab Director: MARK SCHLOTTERBACK
  • NPI Number: 1336679414
  • Taxonomy: 207Q00000X - Family Medicine

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CLIA Record

Field Name Field Value
CLIA Number 03D0952643
LAB Type Physician Office
Facility Name PRIME MEDICAL GROUP
Street 652 E WARNER RD, STE 107
City GILBERT
State AZ
ZIP 85296
Phone 480 539-8680
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 12/8/2024
Certificate Expiration Date 12/7/2026
Facility Type Physician Office
Lab Director MARK SCHLOTTERBACK

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