03D1013102 CLIA NUMBER - AVISTA MEDICAL CENTER

Laboratory Demographics

  • CLIA Code: 03D1013102
  • Facility Name: AVISTA MEDICAL CENTER
  • Facility Address: 690 E WARNER RD, #133
    GILBERT, AZ
    ZIP 85296
  • Facility Phone: 480 892-1212
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: PUNYA RAMAN
  • NPI Number: 1073807202
  • Taxonomy: 207Q00000X - Family Medicine

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CLIA Record

Field Name Field Value
CLIA Number 03D1013102
LAB Type Physician Office
Facility Name AVISTA MEDICAL CENTER
Street 690 E WARNER RD, #133
City GILBERT
State AZ
ZIP 85296
Phone 480 892-1212
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 12/31/2024
Certificate Expiration Date 12/30/2026
Facility Type Physician Office
Lab Director PUNYA RAMAN

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