03D2301141 CLIA NUMBER - MEDIPRO SOLUTIONS PLLC

Laboratory Demographics

  • CLIA Code: 03D2301141
  • Facility Name: MEDIPRO SOLUTIONS PLLC
  • Facility Address: 444 W OSBORN RD
    PHOENIX, AZ
    ZIP 85013
  • Facility Phone: 480 223-9314
  • Facility Type: Physician Office
  • Facility Type: Microscopy
  • Lab Director: SAMANTHA ETIENNE
  • NPI Number: 1548035918
  • Taxonomy: 261QP2300X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 03D2301141
LAB Type Physician Office
Facility Name MEDIPRO SOLUTIONS PLLC
Street 444 W OSBORN RD
City PHOENIX
State AZ
ZIP 85013
Phone 480 223-9314
Certificate Type Certificate for Provider-Performed Microscopy Procedures (PPMP)
Certificate Type Description This certificate is issued to a laboratory in which a physician, midlevel practitioner or dentist performs no tests other than the microscopy procedures. This certificate permits the laboratory to also perform waived tests.
Certificate Effective Date 3/21/2024
Certificate Expiration Date 3/20/2026
Facility Type Physician Office
Lab Director SAMANTHA ETIENNE

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