03D2116836 CLIA NUMBER - EMPACT - SUICIDE PREVENTION CENTER

Laboratory Demographics

  • CLIA Code: 03D2116836
  • Facility Name: EMPACT - SUICIDE PREVENTION CENTER
  • Facility Address: 618 S MADISON DR
    TEMPE, AZ
    ZIP 85281
  • Facility Phone: 480 784-1514
  • Facility Type: Community Clinic
  • Facility Type: Waiver
  • Lab Director: STEPHEN LOPEZ
  • NPI Number: 1255881579
  • Taxonomy: 251S00000X - Community/Behavioral Health

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CLIA Record

Field Name Field Value
CLIA Number 03D2116836
LAB Type Community Clinic
Facility Name EMPACT - SUICIDE PREVENTION CENTER
Street 618 S MADISON DR
City TEMPE
State AZ
ZIP 85281
Phone 480 784-1514
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 8/2/2024
Certificate Expiration Date 8/1/2026
Facility Type Community Clinic
Lab Director STEPHEN LOPEZ

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