03D2099083 CLIA NUMBER - HEART AND VASCULAR SURGICAL CENTER

Laboratory Demographics

  • CLIA Code: 03D2099083
  • Facility Name: HEART AND VASCULAR SURGICAL CENTER
  • Facility Address: 4860 E BASELINE RD SUITE 102
    MESA, AZ
    ZIP 85206
  • Facility Phone: 480 772-0575
  • Facility Type: Ambulatory Surgery Center
  • Facility Type: Waiver
  • Lab Director: RODRIGO CHAN
  • NPI Number: 1881074102
  • Taxonomy: 261QA1903X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 03D2099083
LAB Type Ambulatory Surgery Center
Facility Name HEART AND VASCULAR SURGICAL CENTER
Street 4860 E BASELINE RD SUITE 102
City MESA
State AZ
ZIP 85206
Phone 480 772-0575
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 7/20/2023
Certificate Expiration Date 7/19/2025
Facility Type Ambulatory Surgery Center
Lab Director RODRIGO CHAN

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