03D2112727 CLIA NUMBER - BANNER PHYSICIAN SPECIALISTS ARIZONA LLC

Laboratory Demographics

  • CLIA Code: 03D2112727
  • Facility Name: BANNER PHYSICIAN SPECIALISTS ARIZONA LLC
  • Facility Address: 14416 W MEEKER BLVD, STE 202
    SUN CITY WEST, AZ
    ZIP 85375
  • Facility Phone: 623 876-3800
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: JAMES GORDON
  • NPI Number: 1548538069
  • Taxonomy: 332B00000X - Durable Medical Equipment & Medical Supplies

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CLIA Record

Field Name Field Value
CLIA Number 03D2112727
LAB Type Physician Office
Facility Name BANNER PHYSICIAN SPECIALISTS ARIZONA LLC
Street 14416 W MEEKER BLVD, STE 202
City SUN CITY WEST
State AZ
ZIP 85375
Phone 623 876-3800
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 5/6/2024
Certificate Expiration Date 5/5/2026
Facility Type Physician Office
Lab Director JAMES GORDON

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