03D0933829 CLIA NUMBER - NORTHWEST PRIMARY CARE AT ORO VALLEY

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Field Name	Field Value
CLIA Number	03D0933829
LAB Type	Physician Office
Facility Name	NORTHWEST PRIMARY CARE AT ORO VALLEY
Street	1521 E TANGERINE RD, STE 315
City	ORO VALLEY
State	AZ
ZIP	85755
Phone	520 901-6350
Certificate Type	Certificate of Waiver
Certificate Type Description	This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date	11/3/2023
Certificate Expiration Date	11/2/2025
Facility Type	Physician Office
Lab Director	CORBIN BALLAM

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