CLIA lab
CLIA 03D2019766: Banner Physician Super Specialists Arizona LLC
Mesa, AZ. Certificate and address details from the CMS Provider of Services file for clinical laboratories.
CLIA number 03D2019766 belongs to Banner Physician Super Specialists Arizona LLC in Mesa, AZ.
Certificate of Waiver, effective February 4, 2025, expires February 3, 2027.
Active in the CMS Provider of Services file posted October 16, 2026.
Source: CMS Provider of Services File, Clinical Laboratories (CLIA), as of October 16, 2026. Publisher page
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Certificate
- Certificate type
- Certificate of Waiver
- Certificate effective
- February 4, 2025
- Certificate expiration
- February 3, 2027
- Status in the CMS file
- Active (termination code 00)
- Original participation date
- February 4, 2011
- Facility type
- Other
- Ownership (control type)
- Other
- Lab classification
- CLIA laboratory
Source: CMS Provider of Services File, Clinical Laboratories (CLIA), as of October 16, 2026. Publisher page
Lab and contact
- CLIA number
- 03D2019766
- Lab name
- Banner Physician Super Specialists Arizona LLC
- Address
- 1432 S Dobson Ste 501, Mesa, AZ 85202
- Phone
- (480) 412-7474
- Fax
- (480) 412-7475
Annual test volume the lab reported
- Waived tests
- 200
Volumes are what the lab reported to CMS on its CMS-116 application, as carried in the file.
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- Active Recovery Care, PLLCCertificate of Waiver, Other practitioner03D2175338
- Adelante Healthcare MesaCertificate of Waiver, Federally qualified health center03D0663059
- Advance Home Health Care LLCCertificate of Waiver, Home health agency03D2097527
- Advanced Family Healthcare PLLCCertificate of Waiver, Physician office03D2083155
- Advanced Injury Solutions PLLCCertificate of Waiver, Ambulatory surgery center03D2342127
- Advanced Pain ManagementCertificate of Waiver, Physician office03D2053465
Related
Questions
What is the CLIA number for Banner Physician Super Specialists Arizona LLC in Mesa?
03D2019766, per the CMS Provider of Services file posted October 16, 2026.
What CLIA certificate does Banner Physician Super Specialists Arizona LLC hold?
A Certificate of Waiver, according to the CMS file.
When does CLIA 03D2019766 expire?
The CMS file lists February 3, 2027 as the certificate expiration date; the certificate took effect February 4, 2025.