03D2162996 CLIA NUMBER - OPTUM PRIMARY CARE-CHANDLER

Laboratory Demographics

  • CLIA Code: 03D2162996
  • Facility Name: OPTUM PRIMARY CARE-CHANDLER
  • Facility Address: 600 S DOBSON RD SUITE D27
    CHANDLER, AZ
    ZIP 85224
  • Facility Phone: 480 496-0000
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: TARA OSTROM
  • NPI Number: 1649309816
  • Taxonomy: 261QP2300X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 03D2162996
LAB Type Physician Office
Facility Name OPTUM PRIMARY CARE-CHANDLER
Street 600 S DOBSON RD SUITE D27
City CHANDLER
State AZ
ZIP 85224
Phone 480 496-0000
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 3/5/2025
Certificate Expiration Date 3/4/2027
Facility Type Physician Office
Lab Director TARA OSTROM

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