03D1095623 CLIA NUMBER - ARIZONA PREFERRED PRIMARY CARE

Laboratory Demographics

  • CLIA Code: 03D1095623
  • Facility Name: ARIZONA PREFERRED PRIMARY CARE
  • Facility Address: 3035 S ELLSWORTH RD BLDG 1 SUITE 103
    MESA, AZ
    ZIP 85212
  • Facility Phone: 480 736-1777
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: KAREN M. ACEVEDO-MOGHARBEL
  • NPI Number: 1811941321
  • Taxonomy: 207Q00000X - Family Medicine

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CLIA Record

Field Name Field Value
CLIA Number 03D1095623
LAB Type Physician Office
Facility Name ARIZONA PREFERRED PRIMARY CARE
Street 3035 S ELLSWORTH RD BLDG 1 SUITE 103
City MESA
State AZ
ZIP 85212
Phone 480 736-1777
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 2/12/2025
Certificate Expiration Date 2/11/2027
Facility Type Physician Office
Lab Director KAREN M. ACEVEDO-MOGHARBEL

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