03D0689358 CLIA NUMBER - ARIZONA PEDIATRICS PLLC

Laboratory Demographics

  • CLIA Code: 03D0689358
  • Facility Name: ARIZONA PEDIATRICS PLLC
  • Facility Address: 22 E MITCHELL DR
    PHOENIX, AZ
    ZIP 85012
  • Facility Phone: 602 277-5731
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: ANTSELIOVICH PAVEL
  • NPI Number: 1174913826
  • Taxonomy: 208000000X - Pediatrics

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CLIA Record

Field Name Field Value
CLIA Number 03D0689358
LAB Type Physician Office
Facility Name ARIZONA PEDIATRICS PLLC
Street 22 E MITCHELL DR
City PHOENIX
State AZ
ZIP 85012
Phone 602 277-5731
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 10/7/2024
Certificate Expiration Date 10/6/2026
Facility Type Physician Office
Lab Director ANTSELIOVICH PAVEL

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