03D1051772 CLIA NUMBER - OLD PUEBLO PEDIATRICS, PLLC

Laboratory Demographics

  • CLIA Code: 03D1051772
  • Facility Name: OLD PUEBLO PEDIATRICS, PLLC
  • Facility Address: 3043 WEST INA RD, STE 115
    TUCSON, AZ
    ZIP 85741
  • Facility Phone: 520 797-7070
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: ZEBULON DELP
  • NPI Number: 1376723999
  • Taxonomy: 171W00000X - Contractor

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CLIA Record

Field Name Field Value
CLIA Number 03D1051772
LAB Type Physician Office
Facility Name OLD PUEBLO PEDIATRICS, PLLC
Street 3043 WEST INA RD, STE 115
City TUCSON
State AZ
ZIP 85741
Phone 520 797-7070
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 3/10/2024
Certificate Expiration Date 3/9/2026
Facility Type Physician Office
Lab Director ZEBULON DELP

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