03D2233350 CLIA NUMBER - MOBILE MENDY LLC

Laboratory Demographics

  • CLIA Code: 03D2233350
  • Facility Name: MOBILE MENDY LLC
  • Facility Address: 515 E CAREFREE HWY
    PHOENIX, AZ
    ZIP 85086
  • Facility Phone: 602 769-1137
  • Facility Type: Other - PEDIATRIC MOBILE UC
  • Facility Type: Waiver
  • Lab Director: TARA J. FORSTIE
  • NPI Number: 1770251068
  • Taxonomy: 363LP0200X - Nurse Practitioner

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CLIA Record

Field Name Field Value
CLIA Number 03D2233350
LAB Type Other - PEDIATRIC MOBILE UC
Facility Name MOBILE MENDY LLC
Street 515 E CAREFREE HWY
City PHOENIX
State AZ
ZIP 85086
Phone 602 769-1137
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 8/23/2025
Certificate Expiration Date 8/22/2027
Facility Type Other - PEDIATRIC MOBILE UC
Lab Director TARA J. FORSTIE

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