03D2270446 CLIA NUMBER - MIND 247 PRACTICE LLC METROCENTER ADULT

Laboratory Demographics

  • CLIA Code: 03D2270446
  • Facility Name: MIND 247 PRACTICE LLC METROCENTER ADULT
  • Facility Address: 11046 N METRO PARKWAY WEST SUITE 115
    PHOENIX, AZ
    ZIP 85051
  • Facility Phone: 480 805-1443
  • Facility Type: Community Clinic
  • Facility Type: Waiver
  • Lab Director: JOHN LEE
  • NPI Number: 1487316386
  • Taxonomy: 261QM0801X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 03D2270446
LAB Type Community Clinic
Facility Name MIND 247 PRACTICE LLC METROCENTER ADULT
Street 11046 N METRO PARKWAY WEST SUITE 115
City PHOENIX
State AZ
ZIP 85051
Phone 480 805-1443
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 10/14/2024
Certificate Expiration Date 10/13/2026
Facility Type Community Clinic
Lab Director JOHN LEE

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