03D2119502 CLIA NUMBER - UNIQUE LAB SERVICES, LLC

Laboratory Demographics

  • CLIA Code: 03D2119502
  • Facility Name: UNIQUE LAB SERVICES, LLC
  • Facility Address: 13253 N LA MONTANA DR STE 103
    FOUNTAIN HILLS, AZ
    ZIP 85268
  • Facility Phone: 480 765-2677
  • Facility Type: Mobile Laboratory
  • Facility Type: Waiver
  • Lab Director: JERRY BEOUGHER
  • NPI Number: 1851636435
  • Taxonomy: 291U00000X - Clinical Medical Laboratory

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CLIA Record

Field Name Field Value
CLIA Number 03D2119502
LAB Type Mobile Laboratory
Facility Name UNIQUE LAB SERVICES, LLC
Street 13253 N LA MONTANA DR STE 103
City FOUNTAIN HILLS
State AZ
ZIP 85268
Phone 480 765-2677
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 9/28/2024
Certificate Expiration Date 9/27/2026
Facility Type Mobile Laboratory
Lab Director JERRY BEOUGHER

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