03D0531621 CLIA NUMBER - CLINIC FOR DIGESTIVE DISEASES PC

Laboratory Demographics

  • CLIA Code: 03D0531621
  • Facility Name: CLINIC FOR DIGESTIVE DISEASES PC
  • Facility Address: 13640 N 99TH AVE STE 600
    SUN CITY, AZ
    ZIP 85351
  • Facility Phone: 623 972-2116
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: RAMKRISHNA R. KOTHUR, MD
  • NPI Number: 1093789968
  • Taxonomy: 174400000X - Specialist

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CLIA Record

Field Name Field Value
CLIA Number 03D0531621
LAB Type Physician Office
Facility Name CLINIC FOR DIGESTIVE DISEASES PC
Street 13640 N 99TH AVE STE 600
City SUN CITY
State AZ
ZIP 85351
Phone 623 972-2116
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 RAMKRISHNA R. KOTHUR, MD

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