03D2121574 CLIA NUMBER - MATERNAL FETAL MEDICINE AND GENETICS, PLC

Laboratory Demographics

CLIA Number: 03D2121574

Facility Name: MATERNAL FETAL MEDICINE AND GENETICS, PLC

Facility Address:
1772 E BOSTON ST, STE 107
GILBERT, AZ
ZIP 85295
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Facility Phone Number: (480) 636-6441

Facility Type: PHYSICIAN OFFICE

Certificate Type: Waiver

NPI Number: 1003273822

Taxonomy: 261QM2500X - Clinic/Center
An entity, facility, or distinct part of a facility providing diagnostic, treatment, and prescriptive services related to a specific area of medical specialization. Frequently used for Title V related Children's Specialty services or to meet specific public health needs (e.g., infectious diseases or breast and cervical cancer).

CLIA Record

Field Name	Field Value
CLIA Number	03D2121574
LAB Type	PHYSICIAN OFFICE
Facility Name	MATERNAL FETAL MEDICINE AND GENETICS, PLC
Street	1772 E BOSTON ST, STE 107
City	GILBERT
State	AZ
ZIP	85295
Phone	(480) 636-6441

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This page was last updated on: 5/11/2023