03D1082869 CLIA NUMBER - DR B'S CHILDREN'S OFFICE

Laboratory Demographics

  • CLIA Code: 03D1082869
  • Facility Name: DR B'S CHILDREN'S OFFICE
  • Facility Address: 4524 N MARYVALE PARKWAY #110
    PHOENIX, AZ
    ZIP 85031
  • Facility Phone: 623 845-9009
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: JAMIE A. BALDERRAMA
  • NPI Number: 1801064753
  • Taxonomy: 261Q00000X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 03D1082869
LAB Type Physician Office
Facility Name DR B'S CHILDREN'S OFFICE
Street 4524 N MARYVALE PARKWAY #110
City PHOENIX
State AZ
ZIP 85031
Phone 623 845-9009
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 4/21/2024
Certificate Expiration Date 4/20/2026
Facility Type Physician Office
Lab Director JAMIE A. BALDERRAMA

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This page was last updated on: 3/20/2025