03D2058296 CLIA NUMBER - YAVAPAI PEDIATRICS

Laboratory Demographics

  • CLIA Code: 03D2058296
  • Facility Name: YAVAPAI PEDIATRICS
  • Facility Address: 3001 MAIN STREET, STE 1C
    PRESCOTT VALLEY, AZ
    ZIP 86314
  • Facility Phone: 520 250-3565
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: CLARISA I. SMITH
  • NPI Number: 1609211291
  • Taxonomy: 208000000X - Pediatrics

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CLIA Record

Field Name Field Value
CLIA Number 03D2058296
LAB Type Physician Office
Facility Name YAVAPAI PEDIATRICS
Street 3001 MAIN STREET, STE 1C
City PRESCOTT VALLEY
State AZ
ZIP 86314
Phone 520 250-3565
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 5/3/2025
Certificate Expiration Date 5/2/2027
Facility Type Physician Office
Lab Director CLARISA I. SMITH

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