03D2129785 CLIA NUMBER - PALO VERDE HEMATOLOGY ONCOLOGY DBA ACADEMIC UROLOGY & UROGYNECOLOGY OF AZ

Laboratory Demographics

  • CLIA Code: 03D2129785
  • Facility Name: PALO VERDE HEMATOLOGY ONCOLOGY DBA ACADEMIC UROLOGY & UROGYNECOLOGY OF AZ
  • Facility Address: 519 ROSE LANE
    WICKENBURG, AZ
    ZIP 85390
  • Facility Phone: 623 547-2600
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: JEFFREY STERN
  • NPI Number: 1952007106
  • Taxonomy: 332900000X - Non-Pharmacy Dispensing Site

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CLIA Record

Field Name Field Value
CLIA Number 03D2129785
LAB Type Physician Office
Facility Name PALO VERDE HEMATOLOGY ONCOLOGY DBA ACADEMIC UROLOGY & UROGYNECOLOGY OF AZ
Street 519 ROSE LANE
City WICKENBURG
State AZ
ZIP 85390
Phone 623 547-2600
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 4/25/2023
Certificate Expiration Date 4/24/2025
Facility Type Physician Office
Lab Director JEFFREY STERN

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