03D2308803 CLIA NUMBER - CREOSOTE PSYCHIATRY

Laboratory Demographics

  • CLIA Code: 03D2308803
  • Facility Name: CREOSOTE PSYCHIATRY
  • Facility Address: 8350 S KYRENE RD STE D103
    TEMPE, AZ
    ZIP 85284
  • Facility Phone: 480 269-3208
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: SIMON M. SHEARD
  • NPI Number: 1164138079
  • Taxonomy: 2084P0800X - Psychiatry & Neurology

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CLIA Record

Field Name Field Value
CLIA Number 03D2308803
LAB Type Physician Office
Facility Name CREOSOTE PSYCHIATRY
Street 8350 S KYRENE RD STE D103
City TEMPE
State AZ
ZIP 85284
Phone 480 269-3208
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 8/5/2024
Certificate Expiration Date 8/4/2026
Facility Type Physician Office
Lab Director SIMON M. SHEARD

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