03D1092116 CLIA NUMBER - DESERT KIDS PEDIATRICS, PLC

Laboratory Demographics

  • CLIA Code: 03D1092116
  • Facility Name: DESERT KIDS PEDIATRICS, PLC
  • Facility Address: 6707 N 19TH AVENUE, SUITE 109
    PHOENIX, AZ
    ZIP 85015
  • Facility Phone: 602 973-9234
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: GRAVIOLA R. BROOKS-MARTINEZ, MD
  • NPI Number: 1043461171
  • Taxonomy: 208000000X - Pediatrics

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CLIA Record

Field Name Field Value
CLIA Number 03D1092116
LAB Type Physician Office
Facility Name DESERT KIDS PEDIATRICS, PLC
Street 6707 N 19TH AVENUE, SUITE 109
City PHOENIX
State AZ
ZIP 85015
Phone 602 973-9234
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 11/18/2024
Certificate Expiration Date 11/17/2026
Facility Type Physician Office
Lab Director GRAVIOLA R. BROOKS-MARTINEZ, MD

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