03D1077959 CLIA NUMBER - SOUTHWEST ENDOSCOPY, LLC

Laboratory Demographics

CLIA Number: 03D1077959

Facility Name: SOUTHWEST ENDOSCOPY, LLC

Facility Address:
2223 EAST BASELINE ROAD, STE B
GILBERT, AZ
ZIP 85234
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Facility Phone Number: 480 289-5266

Facility Type: Ambulatory Surgery Center

Certificate Type: Waiver

NPI Number: 1386277069

Taxonomy: 261QA1903X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	03D1077959
LAB Type	Ambulatory Surgery Center
Facility Name	SOUTHWEST ENDOSCOPY, LLC
Street	2223 EAST BASELINE ROAD, STE B
City	GILBERT
State	AZ
ZIP	85234
Phone	480 289-5266
CertificateType	4
CertificateEffectiveDate	12/21/2023
CertificateExpirationDate	12/20/2025
FacilityType	Waiver

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This page was last updated on: 4/23/2024