03D0964569 CLIA NUMBER - SHAILAJA GUNNALA MD PC

Laboratory Demographics

  • CLIA Code: 03D0964569
  • Facility Name: SHAILAJA GUNNALA MD PC
  • Facility Address: 20045 N 19TH AVE, BLDG 11, STE 165
    PHOENIX, AZ
    ZIP 85027
  • Facility Phone: 623 580-7240
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: SHAILAJA GUNNALA MD
  • NPI Number: 1265503221
  • Taxonomy: 207R00000X - Internal Medicine

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CLIA Record

Field Name Field Value
CLIA Number 03D0964569
LAB Type Physician Office
Facility Name SHAILAJA GUNNALA MD PC
Street 20045 N 19TH AVE, BLDG 11, STE 165
City PHOENIX
State AZ
ZIP 85027
Phone 623 580-7240
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 3/1/2024
Certificate Expiration Date 2/28/2026
Facility Type Physician Office
Lab Director SHAILAJA GUNNALA MD

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