03D0881962 CLIA NUMBER - DEDINSKY FAMILY MEDICINE

Laboratory Demographics

  • CLIA Code: 03D0881962
  • Facility Name: DEDINSKY FAMILY MEDICINE
  • Facility Address: 367 E VIRGINIA AVENUE
    PHOENIX, AZ
    ZIP 85004
  • Facility Phone: 602 256-6303
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: BRIAN D. DEDINSKY
  • NPI Number: 1114183209
  • Taxonomy: 261QP2300X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 03D0881962
LAB Type Physician Office
Facility Name DEDINSKY FAMILY MEDICINE
Street 367 E VIRGINIA AVENUE
City PHOENIX
State AZ
ZIP 85004
Phone 602 256-6303
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 7/21/2024
Certificate Expiration Date 7/20/2026
Facility Type Physician Office
Lab Director BRIAN D. DEDINSKY

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