03D2129832 CLIA NUMBER - QC DISTRICT MEDICAL GROUP LLC

Laboratory Demographics

  • CLIA Code: 03D2129832
  • Facility Name: QC DISTRICT MEDICAL GROUP LLC
  • Facility Address: 21323 S ELLSWORTH LOOP RD #101
    QUEEN CREEK, AZ
    ZIP 85142
  • Facility Phone: 480 926-7800
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: JENNIFER FONTIUS
  • NPI Number: 1548734403
  • Taxonomy: 111N00000X - Chiropractor

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CLIA Record

Field Name Field Value
CLIA Number 03D2129832
LAB Type Physician Office
Facility Name QC DISTRICT MEDICAL GROUP LLC
Street 21323 S ELLSWORTH LOOP RD #101
City QUEEN CREEK
State AZ
ZIP 85142
Phone 480 926-7800
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 4/26/2025
Certificate Expiration Date 4/25/2027
Facility Type Physician Office
Lab Director JENNIFER FONTIUS

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