03D2174201 CLIA NUMBER - PRESTIGE PRIMARY CARE, PLLC

Laboratory Demographics

  • CLIA Code: 03D2174201
  • Facility Name: PRESTIGE PRIMARY CARE, PLLC
  • Facility Address: 21321 OCOTILLO RD STE 102
    QUEEN CREEK, AZ
    ZIP 85142
  • Facility Phone: 480 815-7074
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: CANDEE J. EISENHART
  • NPI Number: 1144797374
  • Taxonomy: 363LP2300X - Nurse Practitioner

Map and Directions

Get Directions

CLIA Record

Field Name Field Value
CLIA Number 03D2174201
LAB Type Physician Office
Facility Name PRESTIGE PRIMARY CARE, PLLC
Street 21321 OCOTILLO RD STE 102
City QUEEN CREEK
State AZ
ZIP 85142
Phone 480 815-7074
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 10/29/2023
Certificate Expiration Date 10/28/2025
Facility Type Physician Office
Lab Director CANDEE J. EISENHART

Download Record

Download this CLIA record record in Text format: Export

Download this CLIA record record in Excel (CSV) format: Export

Download this CLIA record record in XML format: Export

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