03D0957406 CLIA NUMBER - CAMELBACK MOUNTAIN MEDICAL ASSOCIATES PC

Laboratory Demographics

  • CLIA Code: 03D0957406
  • Facility Name: CAMELBACK MOUNTAIN MEDICAL ASSOCIATES PC
  • Facility Address: 120 E MONTEREY WAY
    PHOENIX, AZ
    ZIP 85012
  • Facility Phone: 602 266-4383
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: E G. CIPOLLA DO
  • NPI Number: 1164776845
  • Taxonomy: 207Q00000X - Family Medicine

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CLIA Record

Field Name Field Value
CLIA Number 03D0957406
LAB Type Physician Office
Facility Name CAMELBACK MOUNTAIN MEDICAL ASSOCIATES PC
Street 120 E MONTEREY WAY
City PHOENIX
State AZ
ZIP 85012
Phone 602 266-4383
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 2/19/2025
Certificate Expiration Date 2/18/2027
Facility Type Physician Office
Lab Director E G. CIPOLLA DO

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