03D1075753 CLIA NUMBER - TERROS HEALTH SOUTH MOUNTAIN

Laboratory Demographics

  • CLIA Code: 03D1075753
  • Facility Name: TERROS HEALTH SOUTH MOUNTAIN
  • Facility Address: 3540 E BASELINE RD STE 150
    PHOENIX, AZ
    ZIP 85042
  • Facility Phone: 602 685-6000
  • Facility Type: Federally Qualified Health Center
  • Facility Type: Waiver
  • Lab Director: KANINA KEMPTON-MCDONALD
  • NPI Number: 1609251057
  • Taxonomy: 251S00000X - Community/Behavioral Health

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CLIA Record

Field Name Field Value
CLIA Number 03D1075753
LAB Type Federally Qualified Health Center
Facility Name TERROS HEALTH SOUTH MOUNTAIN
Street 3540 E BASELINE RD STE 150
City PHOENIX
State AZ
ZIP 85042
Phone 602 685-6000
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 10/26/2023
Certificate Expiration Date 10/25/2025
Facility Type Federally Qualified Health Center
Lab Director KANINA KEMPTON-MCDONALD

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