03D2277308 CLIA NUMBER - SRP FACILITY, PLLC

Laboratory Demographics

  • CLIA Code: 03D2277308
  • Facility Name: SRP FACILITY, PLLC
  • Facility Address: 11030 N TATUM BLVD STE 101F
    PHOENIX, AZ
    ZIP 85028
  • Facility Phone: 602 889-9880
  • Facility Type: Other - OUTPATIENT TREATMENT CENT
  • Facility Type: Waiver
  • Lab Director: SANJAY PATEL
  • NPI Number: 1801189519
  • Taxonomy: 261QP3300X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 03D2277308
LAB Type Other - OUTPATIENT TREATMENT CENT
Facility Name SRP FACILITY, PLLC
Street 11030 N TATUM BLVD STE 101F
City PHOENIX
State AZ
ZIP 85028
Phone 602 889-9880
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 2/24/2025
Certificate Expiration Date 2/23/2027
Facility Type Other - OUTPATIENT TREATMENT CENT
Lab Director SANJAY PATEL

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