03D1089883 CLIA NUMBER - AZ PEDIATRIC CARE

Laboratory Demographics

  • CLIA Code: 03D1089883
  • Facility Name: AZ PEDIATRIC CARE
  • Facility Address: 9305 W THOMAS RD #410
    PHOENIX, AZ
    ZIP 85037
  • Facility Phone: 623 322-8906
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: BERNARDO O. TAN, MD
  • NPI Number: 1083783724
  • Taxonomy: 261QP2300X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 03D1089883
LAB Type Physician Office
Facility Name AZ PEDIATRIC CARE
Street 9305 W THOMAS RD #410
City PHOENIX
State AZ
ZIP 85037
Phone 623 322-8906
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 6/6/2025
Certificate Expiration Date 6/5/2027
Facility Type Physician Office
Lab Director BERNARDO O. TAN, MD

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