03D2221801 CLIA NUMBER - BATES FAMILY PRACTICE

Laboratory Demographics

  • CLIA Code: 03D2221801
  • Facility Name: BATES FAMILY PRACTICE
  • Facility Address: 520 E BETHANY HOME RD
    PHOENIX, AZ
    ZIP 85012
  • Facility Phone: 602 726-3301
  • Facility Type: Practitioner Other
  • Facility Type: Waiver
  • Lab Director: GINA S. BATES
  • NPI Number: 1336734946
  • Taxonomy: 208D00000X - General Practice

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CLIA Record

Field Name Field Value
CLIA Number 03D2221801
LAB Type Practitioner Other
Facility Name BATES FAMILY PRACTICE
Street 520 E BETHANY HOME RD
City PHOENIX
State AZ
ZIP 85012
Phone 602 726-3301
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 4/23/2025
Certificate Expiration Date 4/22/2027
Facility Type Practitioner Other
Lab Director GINA S. BATES

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