03D1065267 CLIA NUMBER - ASSOCIATED RETINA CONSULTANTS

Laboratory Demographics

  • CLIA Code: 03D1065267
  • Facility Name: ASSOCIATED RETINA CONSULTANTS
  • Facility Address: 1750 E GLENDALE AVE
    PHOENIX, AZ
    ZIP 85020
  • Facility Phone: 480 999-5458
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: BENJAMIN BA BAKALL
  • NPI Number: 1164633160
  • Taxonomy: 207WX0107X - Ophthalmology

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CLIA Record

Field Name Field Value
CLIA Number 03D1065267
LAB Type Physician Office
Facility Name ASSOCIATED RETINA CONSULTANTS
Street 1750 E GLENDALE AVE
City PHOENIX
State AZ
ZIP 85020
Phone 480 999-5458
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 2/26/2025
Certificate Expiration Date 2/25/2027
Facility Type Physician Office
Lab Director BENJAMIN BA BAKALL

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