03D1105926 CLIA NUMBER - ARIZONA SPORTS & SPINE PHYSICIANS PC

Laboratory Demographics

  • CLIA Code: 03D1105926
  • Facility Name: ARIZONA SPORTS & SPINE PHYSICIANS PC
  • Facility Address: 3033 W BELL RD
    PHOENIX, AZ
    ZIP 85053
  • Facility Phone: 602 375-3333
  • Facility Type: Practitioner Other
  • Facility Type: Waiver
  • Lab Director: JOHN S. CHAROCHAK, DO
  • NPI Number: 1194973453
  • Taxonomy: 261QH0100X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 03D1105926
LAB Type Practitioner Other
Facility Name ARIZONA SPORTS & SPINE PHYSICIANS PC
Street 3033 W BELL RD
City PHOENIX
State AZ
ZIP 85053
Phone 602 375-3333
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 9/30/2023
Certificate Expiration Date 9/29/2025
Facility Type Practitioner Other
Lab Director JOHN S. CHAROCHAK, DO

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This page was last updated on: 6/4/2025