03D2173653 CLIA NUMBER - EAST VALLEY OUTPATIENT SURGERY, LLC

Laboratory Demographics

  • CLIA Code: 03D2173653
  • Facility Name: EAST VALLEY OUTPATIENT SURGERY, LLC
  • Facility Address: 5620 E BROADWAY RD STE 102
    MESA, AZ
    ZIP 85206
  • Facility Phone: 417 889-2040
  • Facility Type: Ambulatory Surgery Center
  • Facility Type: Waiver
  • Lab Director: YURI MCKEE
  • NPI Number: 1114465010
  • Taxonomy: 207WX0009X - Ophthalmology

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CLIA Record

Field Name Field Value
CLIA Number 03D2173653
LAB Type Ambulatory Surgery Center
Facility Name EAST VALLEY OUTPATIENT SURGERY, LLC
Street 5620 E BROADWAY RD STE 102
City MESA
State AZ
ZIP 85206
Phone 417 889-2040
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 10/16/2025
Certificate Expiration Date 10/15/2027
Facility Type Ambulatory Surgery Center
Lab Director YURI MCKEE

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