03D2070641 CLIA NUMBER - CARDIOJOST DBA FERGUSON FAMILY MEDICINE

Laboratory Demographics

  • CLIA Code: 03D2070641
  • Facility Name: CARDIOJOST DBA FERGUSON FAMILY MEDICINE
  • Facility Address: 3514 N POWER RD, STE 105
    MESA, AZ
    ZIP 85215
  • Facility Phone: 480 945-4343
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: CHARLES JOST
  • NPI Number: 1023122843
  • Taxonomy: 207RC0000X - Internal Medicine

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CLIA Record

Field Name Field Value
CLIA Number 03D2070641
LAB Type Physician Office
Facility Name CARDIOJOST DBA FERGUSON FAMILY MEDICINE
Street 3514 N POWER RD, STE 105
City MESA
State AZ
ZIP 85215
Phone 480 945-4343
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 12/20/2023
Certificate Expiration Date 12/19/2025
Facility Type Physician Office
Lab Director CHARLES JOST

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