03D0969083 CLIA NUMBER - YOUTH DEVELOPMENT INSTITUTE

Laboratory Demographics

CLIA Code: 03D0969083
Facility Name: YOUTH DEVELOPMENT INSTITUTE
Facility Address: 1830 E ROOSEVELT ST
PHOENIX, AZ
ZIP 85006
Facility Phone: 602 254-0884
Facility Type: Other
Facility Type: Waiver
Lab Director: KENNETH J. ZWIER
NPI Number: 1508939554
Taxonomy: 322D00000X - Residential Treatment Facility, Emotionally Disturbed Children

Map and Directions

Get Directions

CLIA Record

Field Name	Field Value
CLIA Number	03D0969083
LAB Type	Other
Facility Name	YOUTH DEVELOPMENT INSTITUTE
Street	1830 E ROOSEVELT ST
City	PHOENIX
State	AZ
ZIP	85006
Phone	602 254-0884
Certificate Type	Certificate of Waiver
Certificate Type Description	This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date	2/8/2024
Certificate Expiration Date	2/7/2026
Facility Type	Other
Lab Director	KENNETH J. ZWIER

Download Record

Download this CLIA record record in Text format: Export

Download this CLIA record record in Excel (CSV) format: Export

Download this CLIA record record in XML format: Export

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