03D2103461 CLIA NUMBER - BANNER URGENT CARE SERVICES LLC

Laboratory Demographics

  • CLIA Code: 03D2103461
  • Facility Name: BANNER URGENT CARE SERVICES LLC
  • Facility Address: 1157 S CRISMON RD, STE 101
    MESA, AZ
    ZIP 85208
  • Facility Phone: 480 827-5730
  • Facility Type: Other - URGENT CARE
  • Facility Type: Waiver
  • Lab Director: ROBERT JOHNS
  • NPI Number: 1902378524
  • Taxonomy: 261QU0200X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 03D2103461
LAB Type Other - URGENT CARE
Facility Name BANNER URGENT CARE SERVICES LLC
Street 1157 S CRISMON RD, STE 101
City MESA
State AZ
ZIP 85208
Phone 480 827-5730
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 10/13/2023
Certificate Expiration Date 10/12/2025
Facility Type Other - URGENT CARE
Lab Director ROBERT JOHNS

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