03D2303550 CLIA NUMBER - BANNER - UNIVERSITY PRIMARY CARE PHYSICIANS LLC

Laboratory Demographics

  • CLIA Code: 03D2303550
  • Facility Name: BANNER - UNIVERSITY PRIMARY CARE PHYSICIANS LLC
  • Facility Address: 1300 N 12TH ST STE 500
    PHOENIX, AZ
    ZIP 85006
  • Facility Phone: 602 839-4567
  • Facility Type: Physician Office
  • Facility Type: Microscopy
  • Lab Director: JENNA BUCHANAN
  • NPI Number: 1134172679
  • Taxonomy: 261Q00000X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 03D2303550
LAB Type Physician Office
Facility Name BANNER - UNIVERSITY PRIMARY CARE PHYSICIANS LLC
Street 1300 N 12TH ST STE 500
City PHOENIX
State AZ
ZIP 85006
Phone 602 839-4567
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 4/26/2024
Certificate Expiration Date 4/25/2026
Facility Type Physician Office
Lab Director JENNA BUCHANAN

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