03D2043699 CLIA NUMBER - MOSHARRAFA OUTPATIENT SURGERY CENTER, LLC

Laboratory Demographics

  • CLIA Code: 03D2043699
  • Facility Name: MOSHARRAFA OUTPATIENT SURGERY CENTER, LLC
  • Facility Address: 4611 E SHEA BLVD, STE 100
    PHOENIX, AZ
    ZIP 85028
  • Facility Phone: 602 996-4713
  • Facility Type: Ambulatory Surgery Center
  • Facility Type: Waiver
  • Lab Director: TAMIR M. MOSHARRAFA
  • NPI Number: 1639435886
  • Taxonomy: 2086S0122X - Surgery

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CLIA Record

Field Name Field Value
CLIA Number 03D2043699
LAB Type Ambulatory Surgery Center
Facility Name MOSHARRAFA OUTPATIENT SURGERY CENTER, LLC
Street 4611 E SHEA BLVD, STE 100
City PHOENIX
State AZ
ZIP 85028
Phone 602 996-4713
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 7/9/2024
Certificate Expiration Date 7/8/2026
Facility Type Ambulatory Surgery Center
Lab Director TAMIR M. MOSHARRAFA

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