03D2212821 CLIA NUMBER - FULTON AND FULTON, LLC

Laboratory Demographics

  • CLIA Code: 03D2212821
  • Facility Name: FULTON AND FULTON, LLC
  • Facility Address: 560 W BROWN RD STE 1011
    MESA, AZ
    ZIP 85201
  • Facility Phone: 480 509-7738
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: TROY M. FULTON
  • NPI Number: 1790384014
  • Taxonomy: 363LC1500X - Nurse Practitioner

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CLIA Record

Field Name Field Value
CLIA Number 03D2212821
LAB Type Physician Office
Facility Name FULTON AND FULTON, LLC
Street 560 W BROWN RD STE 1011
City MESA
State AZ
ZIP 85201
Phone 480 509-7738
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 2/8/2025
Certificate Expiration Date 2/7/2027
Facility Type Physician Office
Lab Director TROY M. FULTON

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