03D1042934 CLIA NUMBER - INNOVATIVE PRIMARY CARE

Laboratory Demographics

  • CLIA Code: 03D1042934
  • Facility Name: INNOVATIVE PRIMARY CARE
  • Facility Address: 2915 E BASELINE RD
    GILBERT, AZ
    ZIP 85234
  • Facility Phone: 480 776-0626
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: SANDRA L. LEVITT, MD
  • NPI Number: 1669437349
  • Taxonomy: 173000000X - Legal Medicine

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CLIA Record

Field Name Field Value
CLIA Number 03D1042934
LAB Type Physician Office
Facility Name INNOVATIVE PRIMARY CARE
Street 2915 E BASELINE RD
City GILBERT
State AZ
ZIP 85234
Phone 480 776-0626
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 7/12/2025
Certificate Expiration Date 7/11/2027
Facility Type Physician Office
Lab Director SANDRA L. LEVITT, MD

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