03D0959641 CLIA NUMBER - GREAT DESTINATIONS PEDIATRICS PC

Laboratory Demographics

  • CLIA Code: 03D0959641
  • Facility Name: GREAT DESTINATIONS PEDIATRICS PC
  • Facility Address: 7757 W DEER VALLEY RD STE 275
    PEORIA, AZ
    ZIP 85382
  • Facility Phone: 623 878-2800
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: KAREN PRENTICE
  • NPI Number: 1235274051
  • Taxonomy: 208000000X - Pediatrics

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CLIA Record

Field Name Field Value
CLIA Number 03D0959641
LAB Type Physician Office
Facility Name GREAT DESTINATIONS PEDIATRICS PC
Street 7757 W DEER VALLEY RD STE 275
City PEORIA
State AZ
ZIP 85382
Phone 623 878-2800
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 4/15/2025
Certificate Expiration Date 4/14/2027
Facility Type Physician Office
Lab Director KAREN PRENTICE

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