03D2107583 CLIA NUMBER - ARIZONA STATE UROLOGICAL INSTITUTE

Laboratory Demographics

  • CLIA Code: 03D2107583
  • Facility Name: ARIZONA STATE UROLOGICAL INSTITUTE
  • Facility Address: 36493 N GANTZEL RD
    SAN TAN VALLEY, AZ
    ZIP 85140
  • Facility Phone: 480 394-0200
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: JAMES SIEFER
  • NPI Number: 1144231895
  • Taxonomy: 208800000X - Urology

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CLIA Record

Field Name Field Value
CLIA Number 03D2107583
LAB Type Physician Office
Facility Name ARIZONA STATE UROLOGICAL INSTITUTE
Street 36493 N GANTZEL RD
City SAN TAN VALLEY
State AZ
ZIP 85140
Phone 480 394-0200
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 7/28/2024
Certificate Expiration Date 7/27/2026
Facility Type Physician Office
Lab Director JAMES SIEFER

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