03D1047999 CLIA NUMBER - MARK GENTILE MD PC

Laboratory Demographics

  • CLIA Code: 03D1047999
  • Facility Name: MARK GENTILE MD PC
  • Facility Address: 2680 S VAL VISTA DR, BLDG 12, STE 167
    GILBERT, AZ
    ZIP 85295
  • Facility Phone: 480 857-0222
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: MARK J. GENTILE MD
  • NPI Number: 1588777387
  • Taxonomy: 208000000X - Pediatrics

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CLIA Record

Field Name Field Value
CLIA Number 03D1047999
LAB Type Physician Office
Facility Name MARK GENTILE MD PC
Street 2680 S VAL VISTA DR, BLDG 12, STE 167
City GILBERT
State AZ
ZIP 85295
Phone 480 857-0222
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 11/18/2023
Certificate Expiration Date 11/17/2025
Facility Type Physician Office
Lab Director MARK J. GENTILE MD

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