03D0699172 CLIA NUMBER - MOUNTAIN VIEW PEDIATRICS

Laboratory Demographics

  • CLIA Code: 03D0699172
  • Facility Name: MOUNTAIN VIEW PEDIATRICS
  • Facility Address: 77 W FOREST AVE STE 304
    FLAGSTAFF, AZ
    ZIP 86001
  • Facility Phone: 928 214-3600
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: MARY ALICE BERGER
  • NPI Number: 1366562944
  • Taxonomy: 208000000X - Pediatrics

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CLIA Record

Field Name Field Value
CLIA Number 03D0699172
LAB Type Physician Office
Facility Name MOUNTAIN VIEW PEDIATRICS
Street 77 W FOREST AVE STE 304
City FLAGSTAFF
State AZ
ZIP 86001
Phone 928 214-3600
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 7/11/2024
Certificate Expiration Date 7/10/2026
Facility Type Physician Office
Lab Director MARY ALICE BERGER

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