03D1107250 CLIA NUMBER - MOMDOC

Laboratory Demographics

  • CLIA Code: 03D1107250
  • Facility Name: MOMDOC
  • Facility Address: 5656 S POWER RD, SUITE 137
    GILBERT, AZ
    ZIP 85295
  • Facility Phone: 480 821-3610
  • Facility Type: Physician Office
  • Facility Type: Microscopy
  • Lab Director: TAMMI WILLIAMS
  • NPI Number: 1437565876
  • Taxonomy: 207V00000X - Obstetrics & Gynecology

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CLIA Record

Field Name Field Value
CLIA Number 03D1107250
LAB Type Physician Office
Facility Name MOMDOC
Street 5656 S POWER RD, SUITE 137
City GILBERT
State AZ
ZIP 85295
Phone 480 821-3610
Certificate Type Certificate for Provider-Performed Microscopy Procedures (PPMP)
Certificate Type Description This certificate is issued to a laboratory in which a physician, midlevel practitioner or dentist performs no tests other than the microscopy procedures. This certificate permits the laboratory to also perform waived tests.
Certificate Effective Date 1/9/2025
Certificate Expiration Date 1/8/2027
Facility Type Physician Office
Lab Director TAMMI WILLIAMS

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