03D2099911 CLIA NUMBER - WESTERN VASCULAR INSTITUTE, PLLC

Laboratory Demographics

  • CLIA Code: 03D2099911
  • Facility Name: WESTERN VASCULAR INSTITUTE, PLLC
  • Facility Address: 3600 N 3RD AVE STE B
    PHOENIX, AZ
    ZIP 85013
  • Facility Phone: 480 668-5000
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: HENRY S. TARLIAN
  • NPI Number: 1760426001
  • Taxonomy: 174400000X - Specialist

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CLIA Record

Field Name Field Value
CLIA Number 03D2099911
LAB Type Physician Office
Facility Name WESTERN VASCULAR INSTITUTE, PLLC
Street 3600 N 3RD AVE STE B
City PHOENIX
State AZ
ZIP 85013
Phone 480 668-5000
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 8/4/2023
Certificate Expiration Date 8/3/2025
Facility Type Physician Office
Lab Director HENRY S. TARLIAN

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