03D2263527 CLIA NUMBER - SUPERSTITION FAMILY MEDICINE, LLC

Laboratory Demographics

  • CLIA Code: 03D2263527
  • Facility Name: SUPERSTITION FAMILY MEDICINE, LLC
  • Facility Address: 6104 E BROWN RD #102
    MESA, AZ
    ZIP 85205
  • Facility Phone: 480 857-3187
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: JOLENE THWEATT
  • NPI Number: 1295495422
  • Taxonomy: 261QP2300X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 03D2263527
LAB Type Physician Office
Facility Name SUPERSTITION FAMILY MEDICINE, LLC
Street 6104 E BROWN RD #102
City MESA
State AZ
ZIP 85205
Phone 480 857-3187
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 6/29/2024
Certificate Expiration Date 6/28/2026
Facility Type Physician Office
Lab Director JOLENE THWEATT

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