03D2123348 CLIA NUMBER - BANNER URGENT CARE SERVICES LLC

Laboratory Demographics

  • CLIA Code: 03D2123348
  • Facility Name: BANNER URGENT CARE SERVICES LLC
  • Facility Address: 11685 W VAN BUREN
    AVONDALE, AZ
    ZIP 85323
  • Facility Phone: 623 465-6420
  • Facility Type: Other - URGENT CARE
  • Facility Type: Waiver
  • Lab Director: ROBERT JOHNS
  • NPI Number: 1891267407
  • Taxonomy: 261QU0200X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 03D2123348
LAB Type Other - URGENT CARE
Facility Name BANNER URGENT CARE SERVICES LLC
Street 11685 W VAN BUREN
City AVONDALE
State AZ
ZIP 85323
Phone 623 465-6420
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 12/19/2024
Certificate Expiration Date 12/18/2026
Facility Type Other - URGENT CARE
Lab Director ROBERT JOHNS

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This page was last updated on: 3/20/2025