03D2145808 CLIA NUMBER - AHWATUKEE HEALTH CARE LLC

Laboratory Demographics

  • CLIA Code: 03D2145808
  • Facility Name: AHWATUKEE HEALTH CARE LLC
  • Facility Address: 16515 S 40TH ST #119
    PHOENIX, AZ
    ZIP 85048
  • Facility Phone: 480 272-8450
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: KERRY MILLER
  • NPI Number: 1053803676
  • Taxonomy: 207R00000X - Internal Medicine

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CLIA Record

Field Name Field Value
CLIA Number 03D2145808
LAB Type Physician Office
Facility Name AHWATUKEE HEALTH CARE LLC
Street 16515 S 40TH ST #119
City PHOENIX
State AZ
ZIP 85048
Phone 480 272-8450
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 3/15/2024
Certificate Expiration Date 3/14/2026
Facility Type Physician Office
Lab Director KERRY MILLER

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