03D1040482 CLIA NUMBER - DIGNITY HEALTH MEDICAL GROUP FAMILY MEDICINE QUEEN CREEK

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CLIA Record

Field Name Field Value
CLIA Number 03D1040482
LAB Type Physician Office
Facility Name DIGNITY HEALTH MEDICAL GROUP FAMILY MEDICINE QUEEN CREEK
Street 20715 E OCOTILLO RD, STE 102
City QUEEN CREEK
State AZ
ZIP 85142
Phone 480 877-0901
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 5/10/2025
Certificate Expiration Date 5/9/2027
Facility Type Physician Office
Lab Director JAMES SPIVEY

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