03D0533055 CLIA NUMBER - TANQUE VERDE PEDIATRICS

Laboratory Demographics

  • CLIA Code: 03D0533055
  • Facility Name: TANQUE VERDE PEDIATRICS
  • Facility Address: 7507 E TANQUE VERDE RD
    TUCSON, AZ
    ZIP 85715
  • Facility Phone: 520 722-2585
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: JENNIFER B. MOHER
  • NPI Number: 1740494186
  • Taxonomy: 208000000X - Pediatrics

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CLIA Record

Field Name Field Value
CLIA Number 03D0533055
LAB Type Physician Office
Facility Name TANQUE VERDE PEDIATRICS
Street 7507 E TANQUE VERDE RD
City TUCSON
State AZ
ZIP 85715
Phone 520 722-2585
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 10/21/2024
Certificate Expiration Date 10/20/2026
Facility Type Physician Office
Lab Director JENNIFER B. MOHER

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