03D2110594 CLIA NUMBER - AGAVE PEDIATRICS - CHANDLER

Laboratory Demographics

  • CLIA Code: 03D2110594
  • Facility Name: AGAVE PEDIATRICS - CHANDLER
  • Facility Address: 1120 S DOBSON RD, BLDG B, SUITE 125
    CHANDLER, AZ
    ZIP 85286
  • Facility Phone: 480 585-5200
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: RAJEEV AGARWAL
  • NPI Number: 1629076518
  • Taxonomy: 208000000X - Pediatrics

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CLIA Record

Field Name Field Value
CLIA Number 03D2110594
LAB Type Physician Office
Facility Name AGAVE PEDIATRICS - CHANDLER
Street 1120 S DOBSON RD, BLDG B, SUITE 125
City CHANDLER
State AZ
ZIP 85286
Phone 480 585-5200
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 3/21/2024
Certificate Expiration Date 3/20/2026
Facility Type Physician Office
Lab Director RAJEEV AGARWAL

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