03D0956496 CLIA NUMBER - BOOJUM OBSTETRICS AND GYNOCOLOGY PC

Laboratory Demographics

CLIA Number: 03D0956496

Facility Name: BOOJUM OBSTETRICS AND GYNOCOLOGY PC

Facility Address:
3367 S MERCY RD STE 207
GILBERT, AZ
ZIP 85297
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Facility Phone Number: 480 855-5900

Facility Type: Physician Office

Certificate Type: Microscopy

NPI Number: 1912225806

Taxonomy: 174400000X - Specialist
An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree.

CLIA Record

Field Name	Field Value
CLIA Number	03D0956496
LAB Type	Physician Office
Facility Name	BOOJUM OBSTETRICS AND GYNOCOLOGY PC
Street	3367 S MERCY RD STE 207
City	GILBERT
State	AZ
ZIP	85297
Phone	480 855-5900
CertificateType	3
CertificateEffectiveDate	1/28/2023
CertificateExpirationDate	1/27/2025
FacilityType	PPMP

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This page was last updated on: 4/23/2024