03D2121095 CLIA NUMBER - AZ MOBILE MD, LLC

Laboratory Demographics

  • CLIA Code: 03D2121095
  • Facility Name: AZ MOBILE MD, LLC
  • Facility Address: 32819 N 16TH AVE
    PHOENIX, AZ
    ZIP 85085
  • Facility Phone: 623 218-4171
  • Facility Type: Other - MOBILE PHYSICIANS
  • Facility Type: Waiver
  • Lab Director: NAPOLEON RECIA BRAVO
  • NPI Number: 1689126971
  • Taxonomy: 207RG0300X - Internal Medicine

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CLIA Record

Field Name Field Value
CLIA Number 03D2121095
LAB Type Other - MOBILE PHYSICIANS
Facility Name AZ MOBILE MD, LLC
Street 32819 N 16TH AVE
City PHOENIX
State AZ
ZIP 85085
Phone 623 218-4171
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 10/31/2024
Certificate Expiration Date 10/30/2026
Facility Type Other - MOBILE PHYSICIANS
Lab Director NAPOLEON RECIA BRAVO

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