03D0959199 CLIA NUMBER - MARK P SIEGEL DO

Laboratory Demographics

  • CLIA Code: 03D0959199
  • Facility Name: MARK P SIEGEL DO
  • Facility Address: 1530 W GLENDALE AVE STE 103
    PHOENIX, AZ
    ZIP 85021
  • Facility Phone: 602 242-4100
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: MARK P. SIEGEL DO
  • NPI Number: 1487690046
  • Taxonomy: 207Q00000X - Family Medicine

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CLIA Record

Field Name Field Value
CLIA Number 03D0959199
LAB Type Physician Office
Facility Name MARK P SIEGEL DO
Street 1530 W GLENDALE AVE STE 103
City PHOENIX
State AZ
ZIP 85021
Phone 602 242-4100
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 4/5/2025
Certificate Expiration Date 4/4/2027
Facility Type Physician Office
Lab Director MARK P. SIEGEL DO

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