03D2312110 CLIA NUMBER - WATERFORD DX LLC

Laboratory Demographics

  • CLIA Code: 03D2312110
  • Facility Name: WATERFORD DX LLC
  • Facility Address: 6830 N 55TH AVE
    GLENDALE, AZ
    ZIP 85301
  • Facility Phone: 310 503-9177
  • Facility Type: Independent
  • Facility Type: Accreditation
  • Lab Director: DR. SAMIR K. GUNJAN
  • NPI Number: 1679337802
  • Taxonomy: 291U00000X - Clinical Medical Laboratory

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CLIA Record

Field Name Field Value
CLIA Number 03D2312110
LAB Type Independent
Facility Name WATERFORD DX LLC
Street 6830 N 55TH AVE
City GLENDALE
State AZ
ZIP 85301
Phone 310 503-9177
Certificate Type Certificate of Accreditation
Certificate Type Description This is a certificate that is issued to a laboratory on the basis of the laboratory's accreditation by an accreditation organization approved by CMS.
Certificate Effective Date 10/4/2024
Certificate Expiration Date 10/3/2026
Facility Type Independent
Lab Director DR. SAMIR K. GUNJAN

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