03D1100251 CLIA NUMBER - DESERT INTERVENTIONAL SPINE CONSULTANTS, LLC

Laboratory Demographics

  • CLIA Code: 03D1100251
  • Facility Name: DESERT INTERVENTIONAL SPINE CONSULTANTS, LLC
  • Facility Address: 1410 W GUADALUPE, STE 125
    GILBERT, AZ
    ZIP 85233
  • Facility Phone: 480 838-1914
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: AJAY N. YEDDU, MD
  • NPI Number: 1154651750
  • Taxonomy: 174400000X - Specialist

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CLIA Record

Field Name Field Value
CLIA Number 03D1100251
LAB Type Physician Office
Facility Name DESERT INTERVENTIONAL SPINE CONSULTANTS, LLC
Street 1410 W GUADALUPE, STE 125
City GILBERT
State AZ
ZIP 85233
Phone 480 838-1914
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 6/2/2025
Certificate Expiration Date 6/1/2027
Facility Type Physician Office
Lab Director AJAY N. YEDDU, MD

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