03D0712260 CLIA NUMBER - FEDERAL CORRECTIONAL INSTITUTION

Laboratory Demographics

  • CLIA Code: 03D0712260
  • Facility Name: FEDERAL CORRECTIONAL INSTITUTION
  • Facility Address: 37900 N 45TH AVENUE
    PHOENIX, AZ
    ZIP 85086
  • Facility Phone: 623 465-5164
  • Facility Type: Other
  • Facility Type: Waiver
  • Lab Director: SALVATORE A. RICOTTA, MD
  • NPI Number: 1205193893
  • Taxonomy: 261QP0904X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 03D0712260
LAB Type Other
Facility Name FEDERAL CORRECTIONAL INSTITUTION
Street 37900 N 45TH AVENUE
City PHOENIX
State AZ
ZIP 85086
Phone 623 465-5164
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 Other
Lab Director SALVATORE A. RICOTTA, MD

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