03D0862341 CLIA NUMBER - GILBERT CHILDREN'S MEDICAL GROUP INC

Laboratory Demographics

  • CLIA Code: 03D0862341
  • Facility Name: GILBERT CHILDREN'S MEDICAL GROUP INC
  • Facility Address: 4540 E BASELINE RD, SUITE 108
    MESA, AZ
    ZIP 85206
  • Facility Phone: 480 892-3880
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: LAFE J. CARROLL
  • NPI Number: 1427211804
  • Taxonomy: 208000000X - Pediatrics

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CLIA Record

Field Name Field Value
CLIA Number 03D0862341
LAB Type Physician Office
Facility Name GILBERT CHILDREN'S MEDICAL GROUP INC
Street 4540 E BASELINE RD, SUITE 108
City MESA
State AZ
ZIP 85206
Phone 480 892-3880
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 1/8/2025
Certificate Expiration Date 1/7/2027
Facility Type Physician Office
Lab Director LAFE J. CARROLL

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