03D2140550 CLIA NUMBER - MOON VALLEY MEDICAL CENTER, PC

Laboratory Demographics

  • CLIA Code: 03D2140550
  • Facility Name: MOON VALLEY MEDICAL CENTER, PC
  • Facility Address: 13825 N 7TH ST STE A
    PHOENIX, AZ
    ZIP 85022
  • Facility Phone: 602 866-2277
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: LESLIE D. EDISON
  • NPI Number: 1003221185
  • Taxonomy: 152W00000X - Optometrist

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CLIA Record

Field Name Field Value
CLIA Number 03D2140550
LAB Type Physician Office
Facility Name MOON VALLEY MEDICAL CENTER, PC
Street 13825 N 7TH ST STE A
City PHOENIX
State AZ
ZIP 85022
Phone 602 866-2277
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 11/22/2023
Certificate Expiration Date 11/21/2025
Facility Type Physician Office
Lab Director LESLIE D. EDISON

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