03D2153569 CLIA NUMBER - ADOBE PROVIDER GROUP

Laboratory Demographics

  • CLIA Code: 03D2153569
  • Facility Name: ADOBE PROVIDER GROUP
  • Facility Address: 7500 N DREAMY DRAW DR STE 100B
    PHOENIX, AZ
    ZIP 85020
  • Facility Phone: 520 335-3600
  • Facility Type: Practitioner Other
  • Facility Type: Waiver
  • Lab Director: JAYME D. AMBROSE
  • NPI Number: 1659850279
  • Taxonomy: 363L00000X - Nurse Practitioner

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CLIA Record

Field Name Field Value
CLIA Number 03D2153569
LAB Type Practitioner Other
Facility Name ADOBE PROVIDER GROUP
Street 7500 N DREAMY DRAW DR STE 100B
City PHOENIX
State AZ
ZIP 85020
Phone 520 335-3600
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 8/28/2024
Certificate Expiration Date 8/27/2026
Facility Type Practitioner Other
Lab Director JAYME D. AMBROSE

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