03D2211337 CLIA NUMBER - MOBILE NP, PLLC

Laboratory Demographics

  • CLIA Code: 03D2211337
  • Facility Name: MOBILE NP, PLLC
  • Facility Address: 5807 E VERNON AVE
    SCOTTSDALE, AZ
    ZIP 85257
  • Facility Phone: 845 248-1024
  • Facility Type: Practitioner Other
  • Facility Type: Waiver
  • Lab Director: HEIDI A. JACKSON
  • NPI Number: 1184238164
  • Taxonomy: 207Q00000X - Family Medicine

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CLIA Record

Field Name Field Value
CLIA Number 03D2211337
LAB Type Practitioner Other
Facility Name MOBILE NP, PLLC
Street 5807 E VERNON AVE
City SCOTTSDALE
State AZ
ZIP 85257
Phone 845 248-1024
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 1/27/2025
Certificate Expiration Date 1/26/2027
Facility Type Practitioner Other
Lab Director HEIDI A. JACKSON

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