03D2112113 CLIA NUMBER - MIDWESTERN UNIVERSITY COMPREHENSIVE CARE CLINIC

Laboratory Demographics

  • CLIA Code: 03D2112113
  • Facility Name: MIDWESTERN UNIVERSITY COMPREHENSIVE CARE CLINIC
  • Facility Address: 2000 W BETHANY HOME RD STE 200
    PHOENIX, AZ
    ZIP 85015
  • Facility Phone: 602 726-8894
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: AMANDA C. RAPP
  • NPI Number: 1528743754
  • Taxonomy: 207Q00000X - Family Medicine

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CLIA Record

Field Name Field Value
CLIA Number 03D2112113
LAB Type Physician Office
Facility Name MIDWESTERN UNIVERSITY COMPREHENSIVE CARE CLINIC
Street 2000 W BETHANY HOME RD STE 200
City PHOENIX
State AZ
ZIP 85015
Phone 602 726-8894
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 4/22/2024
Certificate Expiration Date 4/21/2026
Facility Type Physician Office
Lab Director AMANDA C. RAPP

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