03D0978054 CLIA NUMBER - SOUTHWEST UROLOGIC SPECIALISTS

Laboratory Demographics

  • CLIA Code: 03D0978054
  • Facility Name: SOUTHWEST UROLOGIC SPECIALISTS
  • Facility Address: 6007 E BASELINE RD #105
    MESA, AZ
    ZIP 85206
  • Facility Phone: 480 897-2727
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: MARY JO WORISCHECK
  • NPI Number: 1134319981
  • Taxonomy: 208800000X - Urology

Map and Directions

Get Directions

CLIA Record

Field Name Field Value
CLIA Number 03D0978054
LAB Type Physician Office
Facility Name SOUTHWEST UROLOGIC SPECIALISTS
Street 6007 E BASELINE RD #105
City MESA
State AZ
ZIP 85206
Phone 480 897-2727
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 9/14/2024
Certificate Expiration Date 9/13/2026
Facility Type Physician Office
Lab Director MARY JO WORISCHECK

Download Record

Download this CLIA record record in Text format: Export

Download this CLIA record record in Excel (CSV) format: Export

Download this CLIA record record in XML format: Export

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