03D0875014 CLIA NUMBER - PHILLIP J DATTILO DO

Laboratory Demographics

  • CLIA Code: 03D0875014
  • Facility Name: PHILLIP J DATTILO DO
  • Facility Address: 1404 EAST PRINCE ROAD
    TUCSON, AZ
    ZIP 85719
  • Facility Phone: 520 327-7494
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: PHILLIP J. DATTILO DO
  • NPI Number: 1861545048
  • Taxonomy: 207R00000X - Internal Medicine

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CLIA Record

Field Name Field Value
CLIA Number 03D0875014
LAB Type Physician Office
Facility Name PHILLIP J DATTILO DO
Street 1404 EAST PRINCE ROAD
City TUCSON
State AZ
ZIP 85719
Phone 520 327-7494
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 8/17/2025
Certificate Expiration Date 8/16/2027
Facility Type Physician Office
Lab Director PHILLIP J. DATTILO DO

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