03D2000921 CLIA NUMBER - ST LUKE'S PEDIATRICS

Laboratory Demographics

  • CLIA Code: 03D2000921
  • Facility Name: ST LUKE'S PEDIATRICS
  • Facility Address: 1310 N 24TH ST STE 150
    PHOENIX, AZ
    ZIP 85008
  • Facility Phone: 602 254-0200
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: GUSTAVO E. DALOLTTO
  • NPI Number: 1306078514
  • Taxonomy: 261QP2300X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 03D2000921
LAB Type Physician Office
Facility Name ST LUKE'S PEDIATRICS
Street 1310 N 24TH ST STE 150
City PHOENIX
State AZ
ZIP 85008
Phone 602 254-0200
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 12/9/2023
Certificate Expiration Date 12/8/2025
Facility Type Physician Office
Lab Director GUSTAVO E. DALOLTTO

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