03D2095291 CLIA NUMBER - BANNER - UNIVERSITY PHYSICIAN SPECIALISTS LLC

Laboratory Demographics

  • CLIA Code: 03D2095291
  • Facility Name: BANNER - UNIVERSITY PHYSICIAN SPECIALISTS LLC
  • Facility Address: 755 E MCDOWELL RD, 3RD FLOOR - NEURO
    PHOENIX, AZ
    ZIP 85006
  • Facility Phone: 844 242-4664
  • Facility Type: Other - HOSPITAL OUTPATIENT DEPT
  • Facility Type: Waiver
  • Lab Director: STEVE CHUNG
  • NPI Number: 1043719669
  • Taxonomy: 332B00000X - Durable Medical Equipment & Medical Supplies

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CLIA Record

Field Name Field Value
CLIA Number 03D2095291
LAB Type Other - HOSPITAL OUTPATIENT DEPT
Facility Name BANNER - UNIVERSITY PHYSICIAN SPECIALISTS LLC
Street 755 E MCDOWELL RD, 3RD FLOOR - NEURO
City PHOENIX
State AZ
ZIP 85006
Phone 844 242-4664
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 5/5/2025
Certificate Expiration Date 5/4/2027
Facility Type Other - HOSPITAL OUTPATIENT DEPT
Lab Director STEVE CHUNG

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