03D2129834 CLIA NUMBER - COOPER MEDICAL GROUP LLC

Laboratory Demographics

  • CLIA Code: 03D2129834
  • Facility Name: COOPER MEDICAL GROUP LLC
  • Facility Address: 2815 E OCOTILLO RD #4
    CHANDLER, AZ
    ZIP 85249
  • Facility Phone: 480 926-7800
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: MARTHA L. REYES
  • NPI Number: 1871067744
  • Taxonomy: 208D00000X - General Practice

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CLIA Record

Field Name Field Value
CLIA Number 03D2129834
LAB Type Physician Office
Facility Name COOPER MEDICAL GROUP LLC
Street 2815 E OCOTILLO RD #4
City CHANDLER
State AZ
ZIP 85249
Phone 480 926-7800
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 4/26/2025
Certificate Expiration Date 4/25/2027
Facility Type Physician Office
Lab Director MARTHA L. REYES

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This page was last updated on: 6/4/2025