03D0987059 CLIA NUMBER - MARK M MEDEIROS

Laboratory Demographics

  • CLIA Code: 03D0987059
  • Facility Name: MARK M MEDEIROS
  • Facility Address: 10210 N 92ND STREET SUITE 305
    SCOTTSDALE, AZ
    ZIP 85258
  • Facility Phone: 480 609-3021
  • Facility Type: Physician Office
  • Facility Type: Microscopy
  • Lab Director: MARK M. MEDEIROS MD
  • NPI Number: 1679570832
  • Taxonomy: 207Q00000X - Family Medicine

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CLIA Record

Field Name Field Value
CLIA Number 03D0987059
LAB Type Physician Office
Facility Name MARK M MEDEIROS
Street 10210 N 92ND STREET SUITE 305
City SCOTTSDALE
State AZ
ZIP 85258
Phone 480 609-3021
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 5/25/2025
Certificate Expiration Date 5/24/2027
Facility Type Physician Office
Lab Director MARK M. MEDEIROS MD

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