03D2011360 CLIA NUMBER - GRACE ZLAKET-MATTA MD, LLC

Laboratory Demographics

  • CLIA Code: 03D2011360
  • Facility Name: GRACE ZLAKET-MATTA MD, LLC
  • Facility Address: 9336 E RAINTREE DR, STE 150
    SCOTTSDALE, AZ
    ZIP 85260
  • Facility Phone: 480 219-5597
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: GRACE ZLAKET-MATTA
  • NPI Number: 1679564512
  • Taxonomy: 207RE0101X - Internal Medicine

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CLIA Record

Field Name Field Value
CLIA Number 03D2011360
LAB Type Physician Office
Facility Name GRACE ZLAKET-MATTA MD, LLC
Street 9336 E RAINTREE DR, STE 150
City SCOTTSDALE
State AZ
ZIP 85260
Phone 480 219-5597
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 8/16/2024
Certificate Expiration Date 8/15/2026
Facility Type Physician Office
Lab Director GRACE ZLAKET-MATTA

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