East Valley Diagnostics LLC
Clinical Medical Laboratory in Mesa, AZ. Organization (NPI-2).
NPI number1104615673
StatusActive
Last updated in NPPESNov 3, 2025
Details
- NPI
- 1104615673
- Entity type
- Organization (NPI-2)
- Legal business name
- East Valley Diagnostics LLC
- Organization subpart
- No
- Enumeration date
- May 2, 2025
- Certification date
- Nov 3, 2025
- Last updated
- Nov 3, 2025
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 291U00000X | Clinical Medical Laboratory | – | – | Yes |
Practice location
2509 S Power Rd Ste 105Mesa, AZ 85209-6696
Phone 623-624-7420 · Fax 623-624-7409
Mailing address
2509 S Power Rd Ste 105Mesa, AZ 85209-6696
Phone 623-624-7420 · Fax 623-624-7409
Authorized official
Jake Gabbard
Ceo
6236247420
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