03D1041200 CLIA NUMBER - PEDIATRAS ARIZONA PLC

Laboratory Demographics

  • CLIA Code: 03D1041200
  • Facility Name: PEDIATRAS ARIZONA PLC
  • Facility Address: 1641 E OSBORN RD, STE 3
    PHOENIX, AZ
    ZIP 85016
  • Facility Phone: 602 218-6397
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: JUAN LLUSCO, MD
  • NPI Number: 1427152164
  • Taxonomy: 208000000X - Pediatrics

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CLIA Record

Field Name Field Value
CLIA Number 03D1041200
LAB Type Physician Office
Facility Name PEDIATRAS ARIZONA PLC
Street 1641 E OSBORN RD, STE 3
City PHOENIX
State AZ
ZIP 85016
Phone 602 218-6397
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 5/25/2025
Certificate Expiration Date 5/24/2027
Facility Type Physician Office
Lab Director JUAN LLUSCO, MD

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