03D0527664 CLIA NUMBER - CHILDREN'S DOCTOR

Laboratory Demographics

  • CLIA Code: 03D0527664
  • Facility Name: CHILDREN'S DOCTOR
  • Facility Address: 5720 N 19TH AVE
    PHOENIX, AZ
    ZIP 85015
  • Facility Phone: 602 864-0211
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: KERAMAT BEHSHAD
  • NPI Number: 1457559486
  • Taxonomy: 282NC2000X - General Acute Care Hospital

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CLIA Record

Field Name Field Value
CLIA Number 03D0527664
LAB Type Physician Office
Facility Name CHILDREN'S DOCTOR
Street 5720 N 19TH AVE
City PHOENIX
State AZ
ZIP 85015
Phone 602 864-0211
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 9/1/2024
Certificate Expiration Date 8/31/2026
Facility Type Physician Office
Lab Director KERAMAT BEHSHAD

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