03D2103455 CLIA NUMBER - PINAL HISPANIC COUNCIL - TUCSON IC

Laboratory Demographics

  • CLIA Code: 03D2103455
  • Facility Name: PINAL HISPANIC COUNCIL - TUCSON IC
  • Facility Address: 1773 W ST MARY RD STE 105
    TUCSON, AZ
    ZIP 85745
  • Facility Phone: 520 721-1887
  • Facility Type: Community Clinic
  • Facility Type: Waiver
  • Lab Director: TAMMY KASTRE
  • NPI Number: 1851651079
  • Taxonomy: 261QP2300X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 03D2103455
LAB Type Community Clinic
Facility Name PINAL HISPANIC COUNCIL - TUCSON IC
Street 1773 W ST MARY RD STE 105
City TUCSON
State AZ
ZIP 85745
Phone 520 721-1887
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 10/13/2023
Certificate Expiration Date 10/12/2025
Facility Type Community Clinic
Lab Director TAMMY KASTRE

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This page was last updated on: 6/4/2025