03D2319869 CLIA NUMBER - SOUTHWEST MEDICAL IMAGING

Laboratory Demographics

  • CLIA Code: 03D2319869
  • Facility Name: SOUTHWEST MEDICAL IMAGING
  • Facility Address: 15000 N 83RD AVE STE 100
    PEORIA, AZ
    ZIP 85381
  • Facility Phone: 480 425-5000
  • Facility Type: Other - OUTPATINET MEDICAL IMAGIN
  • Facility Type: Waiver
  • Lab Director: STACY L. HUNDT
  • NPI Number: 1902896236
  • Taxonomy: 2085R0202X - Radiology

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CLIA Record

Field Name Field Value
CLIA Number 03D2319869
LAB Type Other - OUTPATINET MEDICAL IMAGIN
Facility Name SOUTHWEST MEDICAL IMAGING
Street 15000 N 83RD AVE STE 100
City PEORIA
State AZ
ZIP 85381
Phone 480 425-5000
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 3/10/2025
Certificate Expiration Date 3/9/2027
Facility Type Other - OUTPATINET MEDICAL IMAGIN
Lab Director STACY L. HUNDT

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