03D2015852 CLIA NUMBER - MOMDOC WOMEN FOR WOMEN

Laboratory Demographics

  • CLIA Code: 03D2015852
  • Facility Name: MOMDOC WOMEN FOR WOMEN
  • Facility Address: 37100 N GANTZEL RD, STE 106
    SAN TAN VALLEY, AZ
    ZIP 85140
  • Facility Phone: 480 821-3610
  • Facility Type: Physician Office
  • Facility Type: Microscopy
  • Lab Director: JENNIFER SHAW
  • NPI Number: 1184780355
  • Taxonomy: 207V00000X - Obstetrics & Gynecology

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CLIA Record

Field Name Field Value
CLIA Number 03D2015852
LAB Type Physician Office
Facility Name MOMDOC WOMEN FOR WOMEN
Street 37100 N GANTZEL RD, STE 106
City SAN TAN VALLEY
State AZ
ZIP 85140
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 11/5/2024
Certificate Expiration Date 11/4/2026
Facility Type Physician Office
Lab Director JENNIFER SHAW

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