03D2326109 CLIA NUMBER - MTAC HEALTHCARE PLC

Laboratory Demographics

  • CLIA Code: 03D2326109
  • Facility Name: MTAC HEALTHCARE PLC
  • Facility Address: 560 W BROWN RD STE 1011
    MESA, AZ
    ZIP 85201
  • Facility Phone: 480 864-3671
  • Facility Type: Practitioner Other
  • Facility Type: Waiver
  • Lab Director: ADAM K. ZAMORA
  • NPI Number: 1598557548
  • Taxonomy: 207Q00000X - Family Medicine

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CLIA Record

Field Name Field Value
CLIA Number 03D2326109
LAB Type Practitioner Other
Facility Name MTAC HEALTHCARE PLC
Street 560 W BROWN RD STE 1011
City MESA
State AZ
ZIP 85201
Phone 480 864-3671
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 6/26/2025
Certificate Expiration Date 6/25/2027
Facility Type Practitioner Other
Lab Director ADAM K. ZAMORA

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