03D2302976 CLIA NUMBER - EL MIRAGE ER & MEDICAL CENTER

Laboratory Demographics

  • CLIA Code: 03D2302976
  • Facility Name: EL MIRAGE ER & MEDICAL CENTER
  • Facility Address: 12000 N EL MIRAGE RD
    EL MIRAGE, AZ
    ZIP 85335
  • Facility Phone: 602 214-8061
  • Facility Type: Physician Office
  • Facility Type: Certificate of Compliance
  • Lab Director: CHUKWUEMEKA EZEUME
  • NPI Number: 1760611552
  • Taxonomy: 122300000X - Dentist

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CLIA Record

Field Name Field Value
CLIA Number 03D2302976
LAB Type Physician Office
Facility Name EL MIRAGE ER & MEDICAL CENTER
Street 12000 N EL MIRAGE RD
City EL MIRAGE
State AZ
ZIP 85335
Phone 602 214-8061
Certificate Type Certificate of Compliance
Certificate Type Description This certificate is issued to a laboratory after an inspection that finds the laboratory to be in compliance with all applicable CLIA requirements.
Certificate Effective Date 4/18/2024
Certificate Expiration Date 4/17/2026
Facility Type Physician Office
Lab Director CHUKWUEMEKA EZEUME

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